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The Prognostic Value of the Seventh Day APACHE III Score in Medical Intensive Care Unit (내과계 중환자들의 예후 판정에 었어서 제 7병일 APACHE III 점수의 임상적 유용성)

  • Kim, Mi-Ok;Yun, Soo-Mi;Park, Eun-Joo;Sohn, Jang-Won;Yang, Seok-Chul;Yoon, Ho-Joo;Shin, Dong-Ho;Park, Sung-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.2
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    • pp.236-244
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    • 2001
  • Background : Most current research using prognostic scoring systems in critically ill patients have focused on prediction using the first intensive care unit (ICU) day data or daily updated data. Usually the mean ICU length of stay in Korea is longer than in the western world. Consequently, a more cost-effective and practical prognostic parameter is required. The principal aim of this study was to assess the prognostic value of the seventh day(7th day : the average mean ICU length of stay) APACHE III score in a medical intensive care unit. Methods : 241 medical ICU patients from July 1997 to April 1998 were enrolled. The 1st and 7th scores were measured by using the APACHE III scoring system and compared between survivors and non-survivors. Logistic regression analysis was performed to determine the relationship between the $1^{st}$ and $7^{th}$ APACHE III scores and the mortality risk. Results : 1 )The mean length of stay in the ICU was $10.3{\pm}13.8$ days. 2)The mean $1^{st}$ and $7^{th}$ day APACHE III scores were $59.7{\pm}30.9$ and $37.9{\pm}27.7$. 3) The mean $1^{st}$ day APACHE III score was significantly lower in survivors than in non- survivors($49.9{\pm}23.8$ vs $86.3{\pm}32.3$, P<0.0001). 4)The mean $7^{th}$ day APACHE III score was significantly lower in survivors than in non- survivors($30.1{\pm}18.5$ vs $80.1{\pm}30.4$, P<0.0001). 5)The odds ratios among the $1^{st}$ and $7^{th}$ day APACHE III scores and the mortality rate were 1.0507 and 1.0779 respectively. Conclusion : These results suggest that the seventh day APACHE III score is as useful in predicting the outcome as is such like the first day APACHE III score. Therefore, in comparison to the daily APACHE III score, measuring the $1^{st}$ and $7^{th}$ day APACHE III scores are also useful for predicting the prognosis of critically ill patients in terms of cost-effectiveness. It is suggested that the $7^{th}$ day APACHE III score is useful for predicting the clinical outcome.

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Expression of Estrogen and Progesterone Receptors in Non-small-cell Lung Cancer Tissue Using Tissue Microarray Method (조직 미세배열법을 이용한 비소세포 폐암 조직에서 에스트로겐과 프로게스테론 수용체 발현)

  • Han, Hye-Seung;Kim, Min-Ji;Cho, Jae-Hwa;Yoon, Yong-Han;Kwak, Seung-Min;Lee, Hong-Lyeol;Kim, Kwang-Ho;Ryu, Jeong-Seon
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.54-58
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    • 2005
  • Background : To evaluate the role of estrogen and progesterone in the carcinogenesis of NSCLC, IHC studies for the expression of the receptors of estrogen and progesterone have been performed with inconsistent results. Recently the TMA method has been developed and has become recognized as a useful and rapid method for extensively analysing molecular markers at the gene and protein level. We have investigated their expressions in the tissue from NSCLC using the microarray method. Methods : The TMA construction was made with 70 formalinfixed, paraffin-embedded tissues of NSCLC. After heat-induced epitope retrieval, IHC staining on primary tissues of NSCLC was performed with the monoclonal antibodies, ER1D5 and PR1A6. Results : Our sample of 70 consisted of 74% men and 26% women. Of the patients, 49% were current smokers, 27% were non-smokers and 24% were former smokers. By histologic classification, 34 patients had squamous cell carcinoma, 24 had adenocarcinoma, 9 had adenosquamous cell carcinoma, and 3 had other carcinomas. No cancer cells were immunostained with these monoclonal antibodies in any primary tissues of NSCLC. Conclusions : No expression of neither of the two receptors was found in any of the lung cancer tissues. This suggests that adequate genetic variants for IHC staining need to be developed for NSCLC.

Management of Tuberculosis Outbreak in a Small Military Unit Following the Korean National Guideline (국내 결핵관리지침에 따른 군내 결핵 집단발병 관리 사례 보고)

  • Ji, Sang Hoon;Kim, Hee Jin;Choi, Chang Min
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.5-10
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    • 2007
  • Background: Korean national guidelines for examining contacts with active pulmonary tuberculosis (TB) are a tuberculin skin test (TST) and chest radiographs. The treatment of a latent TB infection as performed only in those younger than six years of age who test positive for TST. Although there is a high incidence of active TB in young Korean soldiers, the current national guidelines for controlling contacts with active TB in soldiers are insufficient. This study highlights the problems with the Korean guidelines for controlling a TB outbreak in a small military unit. Material and Methods: In December of 2005, there was a tuberculosis outbreak in a military unit with a total of 464 soldiers in Kyung Gi province. The chest radiographs were taken of all the soldiers, and TST were carried out on 408 candidates. Results: In the first screening of the chest radiographs, two active TB patients were detected. By August of 2006, four additional cases were detected, making a total of six cases after the outbreak. All the patients showed active pulmonary TB or TB pleuritis. When the results of TST in the close contacts and non-close contacts were compared, there was a significant difference in the absolute size of the induration($9.70{\pm}7.50mm$ vs. $6.26{\pm}7.02mm$, p<0.001) as well as the ratio of patients showing an induration > 10mm (50.0% vs. 32.0%, p<0.001) and 15mm (33.2% vs. 20.9%, p= 0.005). Conclusion: Although the national guidelines for managing a TB outbreak in a military unit were followed, there were continuous instances of new active TB cases. This highlights the need for new guidelines to prevent the spread of TB.

Depression and Anxiety in Outpatients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 우울과 불안심리 평가)

  • Ryu, Yon Ju;Chun, Eun Mi;Sim, Yun Su;Lee, Jin Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.11-18
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    • 2007
  • Background: Patients with chronic obstructive pulmonary disease (COPD) have often been reported to suffer from depression and anxiety possibly due to the exacerbation, hospitalization and mortality of COPD. However,scarce data are available in Korea. This study assessed degree of depression and anxiety, and evaluated the factors associated with depressive symptoms in COPD. Methods: The cross-sectional data on the lung function measurements, smoking behavior, body mass index (BMI), age, gender, depressive symptoms using Beck Depression Inventory (BDI) and anxiety using the State-Trait Anxiety Inventory (STAI) were evaluated in 72 outpatients with COPD and 50 controls without underling lung diseases from September, 2005 to October, 2006 in the Ewha medical center. Results: 1) The age, body mass index (BMI) and serum albumin levels were similar in the patients and controls. The BDI scores (16(0-37) vs. 12(1-30), p=0.001) and the prevalence of depression (36% vs. 6%, p<0.0001) were higher in the COPD patients than in the controls. In the COPD group, the prevalence of depression increased with increasing GOLD stage (p=0.008). The prevalence was 18%(4/22), in mild cases, 30%(6/20) in moderate cases, 52%(13/25) in severe cases and 60%(3/5) in very severe cases. 2) The SAI and TAI scores were higher in the COPD patients (44(20-67) and 47(20-66)) than in the healthy controls (39(26-65) and 44(33-90)). There were a significant correlation between the depression and anxiety scores (p<0.001). 3) A lower BMI, lower postbronchodilator $FEV_1$, current smoking behavior and severity of COPD were univariately associated with the depressive group in COPD, 4) while multivariate logistic analysis revealed only the severe-to-very severe group (OR 3.9, 95% CI 1.2 to 12.9) to be independently associated with depressive symptoms. Conclusion: COPD is strongly associated with depression and anxiety. Therfore, screening for psychological problems in COPD patients is essential, particularly in patients with severe-to-very severe COPD.

Improvement of Cu2ZnSnS4 Solar Cell Characteristics with Zn(Ox,S1-x) Buffer Layer (Zn(Ox,S1-x) 버퍼층 적용을 통한 Cu2ZnSnS4 태양전지 특성 향상)

  • Yang, Kee-Jeong;Sim, Jun-Hyoung;Son, Dae-Ho;Lee, Sang-Ju;Kim, Young-Ill;Yoon, Do-Young
    • Korean Chemical Engineering Research
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    • v.55 no.1
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    • pp.93-98
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    • 2017
  • This experiment investigated characteristic changes in a $Cu_2ZnSnS_4$(CZTS) solar cell by applying a $Zn(O_x,S_{1-x})$ butter layer with various compositions on the upper side of the absorber layer. Among the four single layers such as $Zn(O_{0.76},S_{0.24})$, $Zn(O_{0.56},S_{0.44})$, $Zn(O_{0.33},S_{0.67})$, and $Zn(O_{0.17},S_{0.83})$, the $Zn(O_{0.76},S_{0.24})$ buffer layer was applied to the device due to its bandgap structure for suppressing electron-hole recombination. In the application of the $Zn(O_{0.76},S_{0.24})$ buffer layer to the device, the buffer layer in the device showed the composition of $Zn(O_{0.7},S_{0.3})$ because S diffused into the buffer layer from the absorber layer. The $Zn(O_{0.7},S_{0.3})$ buffer layer, having a lower energy level ($E_V$) than a CdS buffer layer, improved the $J_{SC}$ and $V_{OC}$ characteristics of the CZTS solar cell because the $Zn(O_{0.7},S_{0.3})$ buffer layer effectively suppressed electron-hole recombination. A substitution of the CdS buffer layer by the $Zn(O_{0.7},S_{0.3})$ buffer layer improved the efficiency of the CZTS solar cell from 2.75% to 4.86%.

Emergy Evaluation of the Estuarine Areas of Yeongsan River, Seomjin River, and Han River in Korea (영산강, 섬진강, 한강 하구역의 에머지 평가)

  • Lee, Chang-Hee;Kang, Dae-Seok
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.14 no.2
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    • pp.135-143
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    • 2008
  • An emergy concept was used to evaluate the environment and economy of the estuarine areas of Yeongsan River, Seomjin River, and Han River in Korea. The emergy evaluations clearly showed ecological and socioeconomic characteristics of the estuarine areas that act as ecological and economic centers of surrounding areas. River, tide, and rain provided most of the renewable emergy inputs to the estuarine areas with their contribution to the total emergy input less than 8%. The estuarine areas mostly relied for their operation on the purchased emergy which accounted for $92{\sim}98%$ of the total emergy input to the systems. Emergy indices such as emergy use per unit area, population carrying capacity, environmental loading ratio, and emergy sustainability index revealed that the estuarine areas of Yeongsan River, Seomjin River, and Han River are not sustainable at the current level of economic activities in the areas. The ecological economic values of the environment of the areas were in the range of $7.29{\sim}22.06$ million Em\/ha/yr. They are more than twice that for the whole country, indicating the ecological and economic importance of the eatuarine areas. It is, therefore, urgent to establish and implement estuarine management policies to protect and restore the ecological and economic potentials of the estuarine areas of Yeongsan River, Seomjin River, and Han River. Management plans for the estuarine areas should include both demand-side measures such as reduction of population and economic concentration and consideration of ecological carrying capacity in planning stages for utilization and development of the areas, and supply-side ones such as restoration of degraded ecosystems and construction of new productive ecosystems.

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A Survey on Treatment of Breast Cancer Patients with Korean Medicine: Preliminary Research for Clinical Practice Guidelines (한의표준임상진료지침 개발을 위한 유방암 보완치료 실태조사)

  • Kim, Nam-Hoon;Kang, Na-Hoon;Yoo, Eun-Sil;Park, Nam-Chun;Lee, Jin-Wook;Park, Kyoung-Sun;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Jang, Bo-Hyoung;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.4
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    • pp.165-178
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    • 2018
  • Objectives: To determine the current status of the treatment of breast cancer patients by Korean Medicine doctors (KMDs) and to examine the need for clinical practice guidelines (CPGs) for the supportive care of these patients. Methods: This cross-sectional study used a self-administered questionnaire. Participants were asked about their experience in treating breast cancer patients; the number of breast cancer patients they currently treat; the main complaints expressed by, diagnoses of, and treatments used for such patients; and their opinions about Korean Medicine (KM) as the basis for providing supportive care for breast cancer. Results: The data for this study were collected from 322 respondents. 84 of whom reported having ever treated patients with breast cancer. Most breast cancer patients who visited the KM clinic were classified as stage I or II, and their major complaints were fatigue, general weakness and musculoskeletal pain. The major diagnostic strategies were syndrome differentiation and pulse diagnosis. The major treatments administered were herbal medicine, acupuncture, and moxibustion. KMDs cited a need for medical information, such as CPGs, as their most important concern with regard to the treatment of breast cancer patients. Conclusions: This survey determined the prevalence of the use of KM for Korean breast cancer patients. Our results underscore the need for clinical practice guidelines for using of KM as the basis of supportive care for breast cancer and for informing clinicians and patients about this approach.

Response of Ground Beetles (Coleoptera: Carabidae) to Vegetation Structure in Wildlife Crossings (생태통로 내부 식생구조에 대한 지표성 딱정벌레류(딱정벌레목: 딱정벌레과)의 반응)

  • Jung, Jong-Kook;Park, Yujeong;Lee, Sun Kyung;Lee, Hyoseok;Park, Young-gyun;Lee, Joon-Ho;Choi, Tae Young;Woo, Donggul
    • Korean Journal of Environment and Ecology
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    • v.30 no.2
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    • pp.185-198
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    • 2016
  • Korea has put in significant efforts to increase the number of wildlife crossings between fragmented habitats to prevent loss of biodiversity and to encourage the habitat connectivity in Korea. However, there is a lack of biological data on the effect of vegetation structure in these wildlife crossings and guidelines for design and management of wildlife crossing structures in Korea. Therefore, we selected ground beetle assemblages as model organisms to compare the effect of vegetation structure in wildlife crossings, i.e. bare ground- and shrub-type corridors, in agro-forested landscapes. For this study, 4,207 ground beetles belonging to 33 species were collected through pitfall trapping along the northern forest-corridor-southern forest transects from late April to early September in 2015. Dominant species, abundance, and species richness of ground beetles were significantly higher in the shrub-type corridors than the bare ground-type corridors. Also, the species composition of bare ground-type corridor was significantly different compared to the other habitats such as shrub-type corridor and forests. Similarly, environmental variables were also influenced by vegetation management regimes or trap locations. Collectively, our study clearly indicates that the movement of forest associated ground beetles between forest patches can increase as the vegetation in wildlife crossings becomes complex. Although further studies are needed to verify this, there are indications that the current wildlife crossings that comply with the guidelines may be unfriendly to the movement of ground dwelling arthropods as well as ground beetles. To enhance the ecological function of wildlife crossings, the guidelines need to be rectified as follows: 1) Shrubs or trees should be planted along the corridor verges to provide refuge or movement paths for small mammals and ground dwelling arthropods, and 2) Open spaces should be provided in the middle of the corridors to be used as a path for the movement of large mammals.

Study on the Conservation Management System of China's Natural Reserve (중국 자연보호구의 보전관리체계에 관한 연구)

  • Yao, Zhang;Kim, Dong-Pil;Moon, Ho-Gyeong
    • Korean Journal of Environment and Ecology
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    • v.29 no.3
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    • pp.474-484
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    • 2015
  • This study aims at providing exercisable basic data for the management of protection areas in China by investigating into their legal system such as current laws, regulations, other relevant laws and international treaties and the management system such as history, classification, organization, personnel, funds and main management work.. In People's Republic of China (1954), several laws have been enacted in succession, such as Environment Law (1989), Regulations of Natural Reserves (1994) and Land Management Methods of Natural Reserves (1995). The development process of China's natural reserves is divided into the following five phases. In the initial phase (1956-1965), about 20 natural reserves were established; in the lag phase (1966-1978), a part of the natural reserves was destroyed under the influence of the Great Cultural Revolution; in the development phase (1979-1998), a normative legal system began to appear after the reform and opening up; in the leap phase (1999-2006), the number of natural reserves increased dramatically; in the stable phase ( 2007-present), the protection and restoration of the ecological environment have been implemented, and the supervision and management have been strengthened. China has established natural reserves of national, provincial, municipal and county levels according to the relevant laws. According to the resource categories, natural reserves can be divided into natural ecosystem reserves, wildlife reserves and natural relic reserves. The Ministry of Forestry is in charge of 1,958 natural reserves which account for 74.2 % of the total natural reserves in China. In China, there are 1,384 natural reserves (52.4 %) for which management institutions have been set up. 1,702 natural reserves (64.47 %) are equipped with management staff, showing a higher ratio than the natural reserves which have set up management institutions. China has established natural reserves of national level, provincial level, municipal level and county level according to law. According to the resource categories, natural reserves can be divided into natural ecosystem reserves, wildlife reserves, and natural relic reserves. The Ministry of Forestry is in charge of 1,958 natural reserves which accounts for 74.2 % of the total natural reserves in China. In China, there are 1,384 natural reserves (52.4 %) which have set up management institutions. 1,702 natural reserves (64.47 %) are equipped with management staff with a higher ratio than the natural reserves which have set up management institutions.

Insects Diversity in Urban Green Space (도시 녹지공간의 곤충다양성)

  • Park, Seong-Joon;Lee, Min-Ho;Kim, Jae-Won;Hong, Yong-Sik;Kim, Do-Sung
    • Korean Journal of Environment and Ecology
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    • v.29 no.3
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    • pp.374-390
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    • 2015
  • This study aimed to identify the insect diversity and forest in urban green space, which can determine the current status of the ecosystem and provide basic data and information required for conservation planning and sustainable use of the environment. For this study, we have surveyed insect diversity by habitat types in the botanic garden of Wonkwang University, Iksan, from September, 2010 to September, 2011. During the research period, a total of 209 species, 78 families and 10 orders were observed, including 10 exportable species, 1 species of Korean Red List, 2 climate-sensitive indicator species and 70 designated species. Among these taxonomic groups, Coleoptera (36.36 %) showed the highest diversity with 76 species, followed by Hemiptera (25.36 %) with 46 species, Diptera (11.48 %) with 24 species and Hymenoptera (7.66 %) with 16 species. As for the diversity by survey time, the largest number of species were observed in September 2010 (52 families, 105 species), followed by May 2011 (37 families, 87 species), July 2011 (50 families, 86 species), June 2011 (40 families, 80 species) and August 2011 (43 families, 73 species). Relatively low diversity was observed in September 2011 (38 families, 60 species), October 2010 (36 families, 52 species) and April 2011 (19 families, 29 species). As for the diversity by survey point, the highest diversity was observed in S4 (75 families, 186 species, 88.99 %), followed by S1 (41 families, 70 species, 33.49 %), S2 (41 families, 63 species, 30.14 %), and S3 (36 families, 59 species, 28.22 %). According to the community analysis, the survey area S4 (H'=3.344, RI=9.257) showed the highest numbers in diversity index (H') and richness index (RI) of insects and S1 (0.985) showed the highest species evenness index (EI). On the other hand, S3 showed the lowest numbers (H'=2.428, RI=4.307, EI=0.832) in every index. The insect fauna is closely associated with the plants and vegetation structure in the green space. Therefore, it is necessary to manage and maintain the urban green space to make it similar to the natural environment.