• Title/Summary/Keyword: observational analysis

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Characteristics and outcomes of patients with septic shock who transferred to the emergency department in tertiary referral center: multicenter, retrospective, observational study (상급종합병원 및 종합병원 응급실로 전원된 패혈성 쇼크 환자의 특성과 예후: 다기관 후향적 관찰연구)

  • Kim, Min Gyun;Shin, Tae Gun;Jo, Ik Joon;Kim, Won Young;Ryoo, Seung Mok;Chung, Sung Phil;Beom, Jin Ho;Choi, Sung-Hyuk;Kim, Kyuseok;Jo, You Hwan;Kang, Gu Hyun;Suh, Gil Joon;Shin, Jonghwan;Lim, Tae Ho;Han, Kap Su;Hwang, Sung Yeon;Korean Shock Society (KoSS)
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.465-473
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    • 2018
  • Objective: We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center. Methods: This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality. Results: A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4-9 vs. 6; IQR, 4-8; P<0.001). Mechanical ventilator (29% vs. 21%, P<0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78-1.28; P=0.999) for the transferred group compared with the non-transferred group. Conclusion: The transferred group showed higher severity and needed more organ support procedures than the non-transferred group. However, inter-hospital transfer did not affect in-hospital mortality.

Long-term Efficacy of S-1 Monotherapy or Capecitabine Plus Oxaliplatin as Adjuvant Chemotherapy for Patients with Stage II or III Gastric Cancer after Curative Gastrectomy: a Propensity Score-Matched Multicenter Cohort Study

  • Lee, Chang Min;Yoo, Moon-Won;Son, Young-Gil;Oh, Sung Jin;Kim, Jong-Han;Kim, Hyoung-Il;Park, Joong-Min;Hur, Hoon;Jee, Ye Seob;Hwang, Sun-Hwi;Jin, Sung-Ho;Lee, Sang Eok;Park, Ji-Ho;Seo, Kyung Won;Park, Sungsoo;Kim, Chang Hyun;Jeong, In Ho;Lee, Han Hong;Choi, Sung Il;Lee, Sang-Il;Kim, Chan Young;Kim, In-Hwan;Son, Myoung-Won;Pak, Kyung Ho;Kim, Sungsoo;Lee, Moon-Soo;Min, Jae-Seok
    • Journal of Gastric Cancer
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    • v.20 no.2
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    • pp.152-164
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    • 2020
  • Purpose: To compare long-term disease-free survival (DFS) between patients receiving tegafur/gimeracil/oteracil (S-1) or capecitabine plus oxaliplatin (CAPOX) adjuvant chemotherapy (AC) for gastric cancer (GC). Materials and Methods: This retrospective multicenter observational study enrolled 983 patients who underwent curative gastrectomy with consecutive AC with S-1 or CAPOX for stage II or III GC at 27 hospitals in Korea between February 2012 and December 2013. We conducted propensity score matching to reduce selection bias. Long-term oncologic outcomes, including DFS rate over 5 years (over-5yr DFS), were analyzed postoperatively. Results: The median and longest follow-up period were 59.0 and 87.6 months, respectively. DFS rate did not differ between patients who received S-1 and CAPOX for pathologic stage II (P=0.677) and stage III (P=0.899) GC. Moreover, hazard ratio (HR) for recurrence did not differ significantly between S-1 and CAPOX (reference) in stage II (HR, 1.846; 95% confidence interval [CI], 0.693-4.919; P=0.220) and stage III (HR, 0.942; 95% CI, 0.664-1.337; P=0.738) GC. After adjustment for significance in multivariate analysis, pT (4 vs. 1) (HR, 11.667; 95% CI, 1.595-85.351; P=0.016), pN stage (0 vs. 3) (HR, 2.788; 95% CI, 1.502-5.174; P=0.001), and completion of planned chemotherapy (HR, 2.213; 95% CI, 1.618-3.028; P<0.001) were determined as independent prognostic factors for DFS. Conclusions: S-1 and CAPOX AC regimens did not show significant difference in over-5yr DFS after curative gastrectomy in patients with stage II or III GC. The pT, pN stage, and completion of planned chemotherapy were prognostic factors for GC recurrence.

A Study of the Influence of Short-Term Air-Sea Interaction on Precipitation over the Korean Peninsula Using Atmosphere-Ocean Coupled Model (기상-해양 접합모델을 이용한 단기간 대기-해양 상호작용이 한반도 강수에 미치는 영향 연구)

  • Han, Yong-Jae;Lee, Ho-Jae;Kim, Jin-Woo;Koo, Ja-Yong;Lee, Youn-Gyoun
    • Journal of the Korean earth science society
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    • v.40 no.6
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    • pp.584-598
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    • 2019
  • In this study, the effects of air-sea interactions on precipitation over the Seoul-Gyeonggi region of the Korean Peninsula from 28 to 30 August 2018, were analyzed using a Regional atmosphere-ocean Coupled Model (RCM). In the RCM, a WRF (Weather Research Forecasts) was used as the atmosphere model whereas ROMS (Regional Oceanic Modeling System) was used as the ocean model. In a Regional Single atmosphere Model (RSM), only the WRF model was used. In addition, the sea surface temperature data of ECMWF Reanalysis Interim was used as low boundary data. Compared with the observational data, the RCM considering the effect of air-sea interaction represented that the spatial correlations were 0.6 and 0.84, respectively, for the precipitation and the Yellow Sea surface temperature in the Seoul-Gyeonggi area, which was higher than the RSM. whereas the mean bias error (MBE) was -2.32 and -0.62, respectively, which was lower than the RSM. The air-sea interaction effect, analyzed by equivalent potential temperature, SST, dynamic convergence fields, induced the change of SST in the Yellow Sea. In addition, the changed SST caused the difference in thermal instability and kinematic convergence in the lower atmosphere. The thermal instability and convergence over the Seoul-Gyeonggi region induced upward motion, and consequently, the precipitation in the RCM was similar to the spatial distribution of the observed data compared to the precipitation in the RSM. Although various case studies and climatic analyses are needed to clearly understand the effects of complex air-sea interaction, this study results provide evidence for the importance of the air-sea interaction in predicting precipitation in the Seoul-Gyeonggi region.

Development and Application of an After-school Program for an Astronomy Observation Club in a Highschool: Standardized Coefficient Decision Program in Consideration of the Observation Site's Environment (고등학교 천체 관측 동아리를 위한 방과 후 학교 프로그램 개발 및 적용: 관측지 주변 환경을 고려한 표준화 계수 결정 프로그램)

  • Kim, Seung-Hwan;Lee, Hyo-Nyong;Lee, Hyun-Dong;Jeong, Jae-Hwa
    • Journal of the Korean earth science society
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    • v.29 no.6
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    • pp.495-505
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    • 2008
  • The main purposes of this study are to: (1) to develop astronomy observation program based on a standardized coefficient decision program; and (2) to apply the developed program to after-school or club activities. As a first step, we analyzed activities related to astronomy in the authorized textbooks that are currently adopted in high schools. based on the analysis, we developed an astronomy observation program according to the standardized coefficient decision program, and the program was applied to students' astronomical observations as part of the club activities. Specifically, this program used a 102 mm refracting telescope and digital camera. we took into account the observation site's environment of the urban areas in which many school were located and then developed a the computer program for observation activities. The results of this study are as follows. First, the current astronomical education in schools was based off of the textbooks. Specifically, it was mostly about analyzing the materials and making simulated experiments. Second, most schools participated in this study were located in urban areas where students had more difficulty in observation than in rural areas. Third, an exemplary method was investigated in order to make an astronomical observation efficiently in urban areas with the existing devices. In addition, the standardized coefficient decision program was developed to standardize the magnitude of stars according to the observed value. Finally, based on the students' observations, we found that there was no difference between the magnitude of a star in urban sites and in rural sites. The current astronomical education in schools lacks an activity of practical experiments, and many schools have not good observational sites because they are located in urban areas. However, use of this program makes it possible to collect significant data after a series of standardized corrections. In conclusion, this program not only helps schools to create an active astronomy observation activity in fields, but also promotes students to be more interested in astronomical observation through a series of field-based activities.

A Study on the Environment for Lowbirth Weight Infants in Neonatal Intensive Care Unit in the United States (신생아집중간호단위 환경과 저체중출생아의 반응에 대한 연구)

  • Han Kyung Ja
    • Child Health Nursing Research
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    • v.4 no.2
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    • pp.159-176
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    • 1998
  • In effort to conduct comparative study on the caregiving environment of Neonatal Intensive Care Unit(NICU) in both U. S and Korea, this study was been conducted first in the U.S. Purpose : The purpose of this study is to identify the physical environment and direct caregiving practices to lowbirth weight infants in NICU in the US. It also aims to examine the NICU outcome status and behavioral reponses of lowbirth weight infants. Methods : A study design using descriptive and inferential statistics was been conducted through an observational, field method. A sample of 15 preform infants admitted to NICU were recruited for the study. The subjects were those with birth weight between 1,000 gm to 1,500 gm, born at the gestation period of 27 to 33 weeks, and without any chromosomal or other genetic anomalies, major congenital infections, or maternal illness. Thirty minutes observation(three times of ten minutes of continuous observation)of the infant's behavior and physiological status, and an four-hour observation of the physical environment and direct care giving procedures were been conducted on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. The data to be collected were in four areas : the demograghic characteristics of the infants, the physical environment and care giving procedures, the frequency of the infant's designated behavior and physiological response, and NICU outcome variables. A descriptive analysis and Kruskal-Wallis, Pearson r were been applied according to variable characteristics. Results : 1. Mother's mean age was 29.47. The sample consisted of 6 males and 9 females. Mean gestational ages were 29.17 weeks. Mean birth weight was 1236.33g. Mean Apgar scores at one minute were 6.6, and 7.8 at five minutes. 2. The location for the incubator was in the distance from the light, X-ray screens and nursing station, in proximity to side-lamp, telephone and faucet on the third day after birth. The location for the incubator was in the distance from the light and radio on the tenth day and in proximity to nursing station on the day of dischage from the NICU or at 34weeks postconception. 3. Nesting was the most applying aids to the infants. And foot roll, shielding and plastic frame were frequently using by nurses for facilitating well modulated restful posture. 4. There were statistically significant changes in the patterns of physical environment included locating the infant's incubator and bedding, specific aids to self regulation on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 5. Statistically significant changes were not appeared in the patterns of direct caregiving procedure to the infants included stress inducing or reducing manipulations on the 3rd and 10th day after birth, and on the day of discharge from the NICU or at 34weeks postconception. 6. The stress response of the infants in NICU were significantly reduced as the infants grow older. 7. There were not statistically significant correlation between the physical envronment and the stress responses of the infants in NICU. 8. There were statistically significant correlation between the direct caregiving procedure to the infants and the stress response of the infants in NICU in the second and third observation on the day three. 9. Average weight gain per day from birth to discharge was 38.73g, number of days in the hospital was 42.60, number of days before bottle feeding was 3.6. Postconception age starting bottle feed ing was 31/sup +5/ weeks. Number of days on mechanical ventilator was average 7.64, 11.42 was an average number of days of oxygen need. Conclusion : It, thus, appears that to minimize the sensorymotor stimulation for the low birthweight preterm infant in NICU, manipulation of care giving practices to the babies whatever the stress inducing or reducing procedures, have to be limited in the immediate early stage after birth. And it needed to be reexamine to identify the appropriate and specific physical environment and the patterns of direct caregiving to the low birthweight preform infant as the infants grow older in NICU.

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The Nopsae;a Foehn type wind over the Young Suh region of central Korea (영서지방의 푄현상)

  • ;Lee, Hyon-Young
    • Journal of the Korean Geographical Society
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    • v.29 no.3
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    • pp.266-280
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    • 1994
  • Upper-air synoptic data and surface weather elements such as temperature, relative humidity, wind speed, cloud and precipitation were analyzed in some detail to determine the characteristics of Nopsae, a foehn-like surface wind over the Youngsuh region of Central Korea. NOAA AVHRR and GMS images are also referenced to identify the distribution of clouds and precipitation to classify the tpyes of foehn over the study area. The data period examined is from 1982 until 1993 of spring and summer months from March through August. Results of the anaylsis are as follows. Warm and dry air penetration over the Younesuh region has experienced on foehn days occured between March 21 and August 10 during study perion. The mean annual number of foehn the days were 28. Foehn phenomena were prominent during March 21-25, April 5-15, May 25-June 10, and June 26-30 pentads. The intensity of the phenomena can be evaluated as the difference of daily maximum temperature and relative humidity between windward sites and leeward sites. The intensity of daily maximum temperature reached 14.5$^{\circ}C$, but most values were in the range of 5.0-7.5$^{\circ}C$ (61%). Although strong intensity of foehns usually develop in June, it is common that farmers in the region experince more aridity during the foehnday of April and May due to the transplantation of rice seedlings. Long-run foehn are not common phenomena and 55% of foehn terminate in one day, but there is a record that Nopsae persisted up to 9 days continuously. The author identified using the cloud and precipitation data out of NOAA-11, AVHRR and GMS images is that one of them has no precipitation over windward side. The available data and the results of the analysis are somewhat inadequate. Since the results imply that wave phenomenon is potentially important in terms of local surface weather and vertical momentum transport, more detailed theoretical and observational studies are necessary to clarify the mechanism and the impacts of Nopsae.

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A Study on the Calculation of Evapotranspiration Crop Coefficient in the Cheongmi-cheon Paddy Field (청미천 논지에서의 증발산량 작물계수 산정에 관한 연구)

  • Kim, Kiyoung;Lee, Yongjun;Jung, Sungwon;Lee, Yeongil
    • Korean Journal of Remote Sensing
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    • v.35 no.6_1
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    • pp.883-893
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    • 2019
  • In this study, crop coefficients were calculated in two different methods and the results were evaluated. In the first method, appropriateness of GLDAS-based evapotranspiration was evaluated by comparing it with observed data of Cheongmi-cheon (CMC) Flux tower. Then, crop coefficient was calculated by dividing actual evapotranspiration with potential evapotranspiration that derived from GLDAS. In the second method, crop coefficient was determined by using MLR (Multiple Linear Regression) analysis with vegetation index (NDVI, EVI, LAI and SAVI) derived from MODIS and in-situ soil moisture data observed in CMC, In comparison of two crop coefficients over the entire period, for each crop coefficient GLDAS Kc and SM&VI Kc, shows the mean value of 0.412 and 0.378, the bias of 0.031 and -0.004, the RMSE of 0.092 and 0.069, and the Index of Agree (IOA) of 0.944 and 0.958. Overall, both methods showed similar patterns with observed evapotranspiration, but the SM&VI-based method showed better results. One step further, the statistical evaluation of GLDAS Kc and SM&VI Kc in specific period was performed according to the growth phase of the crop. The result shows that GLDAS Kc was better in the early and mid-phase of the crop growth, and SM&VI Kc was better in the latter phase. This result seems to be because of reduced accuracy of MODIS sensors due to yellow dust in spring and rain clouds in summer. If the observational accuracy of the MODIS sensor is improved in subsequent study, the accuracy of the SM&VI-based method will also be improved and this method will be applicable in determining the crop coefficient of unmeasured basin or predicting the crop coefficient of a certain area.

The Generation of Westerly Waves by Sobaek Mountains (소백산맥에 의한 서풍 파동 발생)

  • Kim, Jin wook;Youn, Daeok
    • Journal of the Korean earth science society
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    • v.38 no.1
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    • pp.24-34
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    • 2017
  • The westerly waves generation is described in the advanced earth science textbook used at high school as follows: as westerly wind approaches and blows over large mountains, the air flow shows wave motions in downwind side, which can be explained by the conservation of potential vorticity. However, there has been no case study showing the phenomena of the mesoscale westerly waves with observational data in the area of small mountains in Korea. And thus the wind speed and time persistency of westerly winds along with the width and length of mountains have never been studied to explain the generation of the westerly waves. As a first step, we assured the westerly waves generated in the downwind side of Sobaek mountains based on surface station wind data nearby. Furthermore, the critical or minimum wind velocity of the westerly wind over Sobaek mountains to generate the downwind wave were derived and calcuated tobe about $0.6m\;s^{-1}$ for Sobaek mountains, which means that the westerly waves could be generated in most cases of westerly blowing over the mountains. Using surface station data and 4-dimensional assimilation data of RDAPS (Regional Data Assimilation and Prediction System) provided by Korea Meteorological Agency, we also analyzed cases of westerly waves occurrence and life cycle in the downwind side of Sobaek mountains for a year of 2014. The westerly waves occurred in meso-${\beta}$ or -${\gamma}$ scales. The westerly waves generated by the mountains disappeared gradually with wind speed decreasing. The occurrence frequency of the vorticity with meso-${\beta}$ scale got to be higher when the stronger westerly wind blew. When we extended the spatial range of the analysis, phenomena of westerly waves were also observed in the downwind side of Yensan mountains in Northeastern China. Our current work will be a study material to help students understand the atmospheric phenomena perturbed by mountains.

Clinical Observational study of Pulmonary Tuberculosis for admitted patients at a National Tuberculosis Hospital - Comparison with the previous results in 1995 - (일개 국립결핵병원에 입원치료를 받은 폐결핵환자의 임상양태에 관한 연구 - 1995년과 2002년 비교연구 -)

  • Park, Seung-Kyu;Lee, In-Hee;Kim, Byoung-Ju
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.4
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    • pp.392-398
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    • 2005
  • Background : The last national tuberculosis survey was carried out in 1995. In 2000, the KTBS(Korean Tuberculosis Surveillance System) replaced a previous national survey. However, the KTBS does not show some of the important epidemiological indexes such as the prevalence of positive tuberculosis or the drug resistance rate. The aim of this study was to compare the clinical features of pulmonary tuberculosis patients admitted to a national tuberculosis hospital in 1995 and 2002. From this study, the authors expect to estimate the trend of the clinical features of tuberculosis in Korea even though it can not represent the Korean tuberculosis situation as a whole. Method : A cross sectional analysis of the clinical features for 331 pulmonary tuberculosis in-patients admitted to the National Masan Tuberculosis Hospital as of Dec. 2002, was carried out and these results were compared with those reported in 1995. Results : In comparison with the data reported in 1995, the mean age was increased by 3.6 years ($44.1{\pm}14.6$ vs $47.7{\pm}16.4$, p<0.01). The number of past tuberculosis history and used anti-tuberculous drugs prior to admission decreased from $2.0{\pm}1.7$ and $6.1{\pm}2.3$ to $1.7{\pm}1.8$ and $4.6{\pm}3.6$(p<0.05, p<0.001), respectively. While the resistance rate for anti-tuberculous drugs was similar (81.0% vs 77.6%), the initial resistance rate(10.5% vs 21.4%) and initial MDR rate(2.4% vs 16.5%) increased significantly(p=0.012, p=0.001, respectively). In 1995, the public health communities were in charge of approximately 65% of newly diagnosed tuberculosis cases, but this reduced to 40.5% in 2002(p<0.001). Conclusion : The existing national TB program (NTP) needs to be revised and strengthened in order to cope with the unfavorably changing situation of the domestic TB problem because the number of TB patients has not decreased and the initial resistance rate has increased greatly. Furthermore, the public and private sectors should cooperate each other to control the TB problem effectively because the private sector is now managing more than half of the TB patients.

Clinical Spectrum and Short-term Effects of Enzyme Replacement Therapy for Mucopolysaccharidosis Type II (제2형 뮤코다당증의 임상적 스펙트럼과 효소대치요법의 단기간 효과)

  • Cheon, Chong Kun;Hwu, Wuh-Liang
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.3
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    • pp.78-86
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    • 2018
  • Purpose: We aimed to delineate clinical spectrum and short-term effects after enzyme replacement therapy (ERT) for 5 mucopolysaccharidosis type II (MPS II). Methods: Five patients were diagnosed with MPS II by clinical findings, enzyme activity, and genetic testing. Idursulfase was administered by intravenous infusion at a dose of 0.5 mg/kg every week. Observational chart analysis of patients, who underwent systematic investigations more than 12 months after initiation of ERT was done retrospectively. Results: Three patients were classified as having the attenuated type, and 2 patients were classified as having the severe type. The median age at the diagnosis was 9.6 years (range 3.4-26 years). Four different mutations in 5 Korean patients (4 families) with MPS II were identified, among which two were novel mutations (1 small insertion mutation: p.Thr409Hisfs*22, and 1 missense mutation: p.Gly134Glu). Two severe type sibling patients with the same mutation had different clinical manifestation. Urinary glycosaminoglycan excretion decreased within the twelve months of ERT (P=0.043). Liver and spleen volumes showed reductions that were maintained in all patients (P=0.043 and P=0.043, respectively). Improvements were also noted in left ventricular mass index (P=0.042), shoulder flexion (P=0.043), shoulder abduction (P=0.039), knee flexion (P=0.043), elbow flexion (P=0.042), and respiratory distress index (P=0.041). Conclusion: This study demonstrates that Korean patients with MPS II are clinically heterogeneous and indicates that idursulfase is relatively effective in several clinical parameters including heart size and respiratory distress index without infusion-related reactions in patients with MPS II.

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