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Predictors on In-hospital Mortality Following In-hospital Diagnosis of Tuberculosis (결핵으로 입원한 환자의 병원내 사망과 관련된 인자)

  • Shin, Su Rin;Kim, Chang Hwan;Kim, Sung Eun;Park, Yong Bum;Lee, Jae Young;Mo, Eun Kyung;Kim, Cheol Hong;Eom, Kwang Seok;Jang, Seung Hun;Kim, Dong Gyu;Lee, Myung Gu;Jung, Ki Suck
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.233-238
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    • 2006
  • Study objectives: To determine the factors associated with mortality after an in-hospital diagnosis of tuberculosis in a region with low levels of HIV coinfection. Methods: From January 2003 to December 2004, all subjects who were > 15 years of age and had received a diagnosis of tuberculosis were registered. The clinical, radiological and laboratory aspects of the patients who died (n=27) were compared with those of an age and gender matched control population(n=54). Logistic regression analyses were carried out, which included age, gender, hospital admission source, initial site of admission, dyspnea, general weakness and initial laboratory data. Results: The mean age of the patients was $60{\pm}16$ years and male patients outnumbered female patients. Univariate analysis identified hemoglobin, blood urea nitrogen, albumin, cholesterol, aspartate aminotransferase (AST), C-reactive protein and the risk factors for tuberculosis to be significantly associated with mortality. Among the characteristics of disease presentation and treatment, emergency department admission, intensive care unit, disease severity, general weakness and dyspnea at the time of admission were associated with mortality. Multiple regression analysis revealed the initial management in the intensive care unit and lower serum albumin to be independently associated with mortality. Conclusion: The markers of disease chronicity and severity appear to be associated with in-hospital mortality. Identifying potentially reversible factors such as malnutrition and respiratory failure suggests specific intervention that might lead to an improvement in the patients' outcomes.

A Study on the Determination of Optimal Location and Size for Underground Sluiceway Design (지하방수로 설계를 위한 적정 위치선정 및 규모 결정에 관한 연구)

  • Lee, Jong-Tae;Lim, Taek-Sun;Hur, Sung-Chul;Park, Sang-Sik
    • Journal of the Korean Society of Hazard Mitigation
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    • v.8 no.5
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    • pp.137-145
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    • 2008
  • In this study, to reduce the flood damage caused by flood discharge exceeding project flood, the primary technology was applied to determining the optimal location and size for underground sluiceway. The Jungrang Stream was selected for this study because the stream was overflowed and the embankment section of the stream was destroyed owing to localized torrential rainfall in 1998 and 2001. Considering 200-year frequency storm, the inlets of the underground discharge channel were located at Seoul City limits, the confluence of Danghyun Stream, Wolgye 1-gyo, and the confluence of Mukdong Stream. The outlets were located at the estuary of Jungrang Stream and rightbank of Banpo Bridge in Han River. The transverse discharge according to the variation of overflow depth at the inlet of underground discharge channel was estimated and the effect of inundation reduction was analyzed. To examine the appropriate scale of the underground discharge channel, the 8 operation methods for the management of outlet discharge were compared considering four rules (only storage, the constant discharge rate, the constant discharge volume, and the mixture of the constant discharge rate and discharge volume). As a result, the effect of inundation reduction was most significantly improved when the inlet was located at the confluence of Danghyun Stream. The appropriate size of underground sluiceway for 200-year frequency storm was studied, and as a result, the appropriate diameters of the underground discharge channel were 12 m in case of only storage(Rule D), 9m in 50% of discharge(Rule E), 8 m in constant discharge volume(Rule F), and 7 m in mixture method(Rule G). This investigation process can be applied to design the underground discharge channel when the inundation damage is significant in coastal area due to embankment overflow. The underground discharge channel in Jungrang Stream can also be used as an underground road to link Seoul City to Uijeongbu City during dry season.

A Study of Content Analysis on ICU(Intensive Care Unit) Nurses' Knowledge of Basic Nursing Sciences (중환자실 간호사의 기초간호과학 지식의 필요성 분석)

  • Byeon, Young-Soon;Choe, Myoung-Ae;Kim, Hee-Seung;Park, Mi-Jung;Seo, Wha-Sook;Lee, Kyung-Sook;Choi, S-Mi;Hong, Hae-Sook
    • Journal of Korean Biological Nursing Science
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    • v.4 no.1
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    • pp.41-49
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    • 2002
  • The purpose of this study was to identify the knowledge contents of basic nursing sciences needed by nurses in the practices of the intensive care unit(ICU). To attain the goal of this study, the nurses working at 10 hospitals in the areas of Seoul and Kangwon Province were randomly selected. They were primarily interviewed, and the open question was secondarily put to them through the questionnaire. In the process of the 1st interview, the interviewees were asked of the question, "What is the knowledge of basic sciences such as anatomy, pathology, physiology. microbiology, pharmacology and the like thought to be lacking when you communicate with doctors in the ICU and when you carry out your nursing practices in it?" The contents of the interview were tape-recorded. The period of data collection ranged from May 1, 2001 to Sept 30. The interviews were conducted with total of 20 nurses. The open-end questionnaire was secondarily mailed to nurses. 113 questionnaires were returned. 100 questionnaires except 13 ones thought to be poorly completed in content were used for data analysis. Three coders classified data obtained from the interview and the questionnaire research into 5 detailed items relating to such as anatomical physiology, pathology, pharmacology. microbiology and basics of nursing. The three coders had experiences in nursing education of 18 years, 8 years and 6 years, respectively, and of them one coder was professor in basic nursing sciences. Data were statistically treated using frequency analysis and percentage by the SAS program. As a result, the following findings were obtained : It was found that the contents that ICU nurses responded were most needed in the field of Human structure and function were water and electrolytic balance(38%), blood and circulatory system(20%), changer in the patient's skin(12%), the arrangement of the human body(10%) and the endocrine system(10%), nervous system(6%), and assessment of the state of the patient's consciousness(4%). It was found that the contents that ICU nurses responded were most needed in the field of pathology were found to be the process of the progress of the disease(32%), symptoms of the disease(27%), prognosis of the disease(22%), followed by the injury-healing process, clinical pathological examination, and examination by radiation. It was found that the contents that nurses responded were most needed in the field of pharmacology were the effect of drug(25%), the side effect of drug(22%), the relationship between diseases and drug(20%), the relationship between disease-causing bacteria and drug(20%) and chemotherapy(2%). It was found that the contents that ICU nurses responded were most needed in the field of microbiology were the relationship between diseases and disease-causing bacteria(45%), Kinds and characteristics of disease-causing bacteria(18%), infection control(16%), application of the aseptic technique(12%), isolation(9%) and the like. It was found that the basic knowledge that ICU nurses responded were needed were the identification of the patient's current state(36%), understanding of the therapeutic process(22%), the operating principle of medical equipment and instrument(20%), medical terminology(9%), equipment and instrument management(7%), calculation of the dose of injection(2%) and the like.

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Comparision of Family Environment, Health Behavior and Health State of Elementary Students in Urban and Rural Areas (도시.농촌 지역 초등학생의 가족환경, 건강행위 및 건강상태에 관한 비교)

  • Bae, Yeon-Suk;Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.502-517
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    • 1998
  • This research intends to survey family environment, health behavior and health status of the students in urban-rural elementary schools and analyze those factors comparatively, and use the result as basic material for school health teacher to teach health education in connection with family and regional areas. It also intends to improve a pupil's self-abilitiy in health care. The subjects involve 2,774 students of urban elementary schools and 583 student in rural ones, who were selected by means of a multi -stage probability sampling. Using the questionnaire and school documents, we collected data on family environment, health behavior and health status for 19 days. Feb. 2nd 1998 through Feb. 20th 1998. The R -form of Family Environment Scale (Moos, 1974) was used in the analysis of family environment(Cronbach's Alpha =0.80). Questionnaires of Health Behavior in School-aged children used by the WHO in Europe(Aaro et al., 1986) and the ones developed by the Health Promotion Committee of the Western Pacific(WHO, 1995)(adapted by long Young-suk and Moon Young-hee(1996)) were used in the analysis of health behavior, as well documents on absences due to sickness, school health room-visits, levels of physical strength, height, weight and degree of obesity were used to determine health status. In next step, We used them with an $X^2$-test, t-test, Odds Ratio, and a 95% Confidence Interval. 1. In two dimensions of three, family-relationship (t=3.41, p=0.001) and system -maintenances(t= 2.41, p=0.0l6) the mean score of urban children were significantly higher than those of rural ones. In the personal development dimension however, there was little significant difference. Assorting family environment into 10 sub-fields and analyzing them, we recognized that urban children were superior to rural children in the sub-fields of expressiveness (t =3.47, p=0.001), conflict (t=0.48, p=0.001), active-recreational orientation (t = 1.97, p=0.049) and organization (t=4.33, p=0.000). 2. Referring to the Odds Ratios of urban-rural children's health behaviors, urban children set up more desirable behavior than rural children wear ing safety belts (Odds Ratio =0.32, p=0.000), washing hands after meals(Odds Ratio = 0.43, p= 0.000), washing hands after excreting (Odds Ratio = 0.39, p=O.OOO), washing hands after coming - home ( Odds Ratio = 0.75, p = 0.003), brushing teeth before sleeping(Odds Ratio =0.45, p=0.000), brushing teeth more than once a day (Odds Ratio =0.73, p=0.0l2), drinking boiled water (Odds Ratio = 0.49, p=0.000), collecting garbage at home(Odds Ratio=0.31, p=0.000) and in the school(Odds Ratio =0. 67, p=0.000). All these led to significant differences. As to taking milk(Odds Ratio = 1.50, p=0.000), taking care of eyesight(Odds Ratio=1.41, p=0.001) and getting physical exercise in(Odds Ratio = 1.33, p=0.0l9) and outside the school(Odds Ratio = 1.32, p=0.005), rural children had more desirable behavior which also revealed a significant difference. There was little significant difference in smoking, but the smoking rate of rural children(5.5%) was larger than that of urban children(3.9%). 3. Health status was analyzed in terms of absences, school health room-visits, levels of physical strength, and the degree of obesity, height and weight. Considering Odds Ratios of the health status of urban-rural children, the health status of rural children was significantly better than that of the urban ones in the level of physical strength(t=1.51, p=0.000) and the degree of obesity(t=1.84, p=0.000). The mean height of urban children ($150.4{\pm}7.5cm$) is taller than that of their counterparts($149.5{\pm}7.9$), which revealed a significant difference (t =2.47, p=0.0l4). The mean weight of urban children($42.9{\pm}8.6kg$) is larger than that of their counterparts($41.8{\pm}9.0kg$), which was also a significant difference(t=2.81, p=0.005). Considering the results above, we can recognize that there are significant differences in family environment, health behavior, and health status in urban-rural children. These results also suggestion ideas for health education. What we would suggest for the health program of elementary schools is that school health teachers should play an active role in promoting the need and importance of health education, develop the appropriate programs which correspond to the regional characteristics, and incorporate them into schools to improve children's ability to manage their own health management.

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Atmospheric Vertical Structure of Heavy Rainfall System during the 2010 Summer Intensive Observation Period over Seoul Metropolitan Area (2010년 여름철 수도권 집중관측기간에 나타난 호우 시스템의 대기연직구조)

  • Kim, Do-Woo;Kim, Yeon-Hee;Kim, Ki-Hoon;Shin, Seung-Sook;Kim, Dong-Kyun;Hwang, Yoon-Jeong;Park, Jong-Im;Choi, Da-Young;Lee, Yong-Hee
    • Journal of the Korean earth science society
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    • v.33 no.2
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    • pp.148-161
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    • 2012
  • The intensive observation (ProbeX-2010) with 6-hour launches of radiosonde was performed over Seoul metropolitan area (Dongducheon, Incheon Airport, and Yangpyeong) from 13 Aug. to 3 Sep. 2010. Five typical heavy rainfall patterns occurred consecutively which are squall line, stationary front, remote tropical cyclone (TC), tropical depression, and typhoon patterns. On 15 Aug. 03 KST, when squall line developed over Seoul metropolitan area, dry mid-level air was drawn over warm and moist low-level air, inducing strong convective instability. From 23 to 26 Aug and from 27 to 29 Aug. Rainfall event occurred influenced by stationary front and remote TC, respectively. During the stationary frontal rainy period, thermal instability was dominant in the beginning stage, but dynamic instability became strong in the latter stage. Especially, heavy rainfall occurred on 25 Aug. when southerly low level jet formed over the Yellow Sea. During the rainy period by the remote TC, thermal and dynamic instability sustained together. Especially, heavy rainfall event occurred on 29 Aug. when the tropical air with high equivalent potential temperature (>345 K) occupied the deep low-middle level. On 27 Aug. and 2 Sep. tropical depression and typhoon Kompasu affected Seoul metropolitan area, respectively. During these events, dynamic instability was very strong.

Development of Simple and Rapid Radioactivity Analysis for Thorium Series in the Products Containing Naturally Occurring Radioactive Materials (NORM) (천연방사성물질(NORM)을 함유한 가공제품 내 토륨계열 방사능 평가를 위한 간단/신속 분석법 개발)

  • Yoo, Jaeryong;Park, Seyoung;Yoon, Seokwon;Ha, Wi-Ho;Lee, Jaekook;Kim, Kwang Pyo
    • Journal of Radiation Protection and Research
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    • v.41 no.1
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    • pp.71-79
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    • 2016
  • Background: It is necessary to analyze radioactivity of naturally occurring radioactive materials (NORM) in products to ensure radiological safety required by Natural Radiation Safety Management Act. The pretreatments for the existing analysis methods require high technology and time. Such destructive pretreatments including grinding and dissolution of samples make impossible to reuse products. We developed a rapid and simple procedure of radioactivity analysis for thorium series in the products containing NORM. Materials and Methods: The developed method requires non-destructive or minimized pretreatment. Radioactivity of the product without pretreatment is initially measured using gamma spectroscopy and then the measured radioactivity is adjusted by considering material composition, mass density, and geometrical shape of the product. The radioactivity adjustment can be made using scaling factors, which is derived by radiation transport Monte Carlo simulation. Necklace, bracelet, male health care product, and tile for health mat were selected as representative products for this study. The products are commonly used by the public and directly contacted with human body and thus resulting in high radiation exposure to the user. Results and Discussion: The scaling factors were derived using MCNPX code and the values ranged from 0.31 to 0.47. If radioactivity of the products is measured without pretreatment, the thorium series may be overestimated by up to 2.8 times. If scaling factors are applied, the difference in radioactivity estimates are reduced to 3-24%. Conclusion : The developed procedure in this study can be used for other products with various materials and shapes and thus ensuring radiological safety.

Effect of Short Term Treatment with Different Dosage of Inhaled Flucatisone Propionate on Basal Cortisol Concentration (단기간 Fluticasone Propionate 투여 용량에 따른 가저 코르티솔 농도의 변화)

  • Kim, Hyun-Jung;Kim, Hyoung-Sik;Lee, Hong;Moon, Sung-Gi;Lim, Seok-Tae;Park, Ji-Hyun;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1063-1071
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    • 1997
  • Backgroung : The efficacy of oral corticosteroids in the treatment of chronic asthma is undisputed, but their long-term use is associated with adverse side-effects, including supression of the hypothalamic-pituitary adrenal axis function, osteoporosis, weight gain, hypertension and impaired glucose tolerance. The introduction of inhaled corticosteroids in the early 1970's represented a significant therapeutic advance in the management of asthma, since these compounds combined high topical potency with low systemic activity. Fluticasone propionate is a new topically active synthetic glucocorticosteroid that combinds a high degree of efficacy with negligible systemic bioavailability. This study was perfomed to determine the effect of inhaled fluticasone propionate on the adreocortical supression in patients with bronchial asthma or chronic obstructive pulmonary disease. Method : The adrenocortical function was assessed by measurement of plasma cortisol concentration at 8 o'clock in morning and free cortisol in 24 hour urine collection at interval. Absolutely, no steroid was taken during pretreatment period of 10days. There after each subject inhaled fluticasone aerosol, in daily doses of 500 or 1000micrograms for 12days. The dose was delivered by metered dose inhaler(MDI). Results : The serum cortisol and 24hour urinary free cortisol were not decreased during the treatment period in patients with inhaled fluticasone propionate in daily doses of 500 micrograms. In contrast, serum cortisol was significantly decreased on 9th and 12th day(p less than 0.05). And, 24hour urinary free cortisol was also significantly decreased on 3rd and 12th day of treatement period(p less than 0.05) in patients with inhaled fluticasone in daily doses of 1000 micrograms. Conclusion : These results suggested that endogenous cortisol secretion was not supressed after short-term inhalation of fluticasone in daily dose of 500 micrograms, but in daily dose of 1000 micrograms, the endogenous cortisol secretion was supressed.

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Elevated C-reactive Protein Levels are a Sign of Pulmonary Arterial Hypertension in AECOPD (만성 폐쇄성 폐질환 급성 악화 시 C-반응단백과 폐동맥 고혈압의 관계)

  • Kim, So Ri;Choe, Yeong Hun;Lee, Ka Young;Min, Kyung Hoon;Park, Seoung Ju;Lee, Heung Bum;Lee, Yong Chul;Rhee, Yang Keun
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.125-132
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    • 2008
  • Background: In chronic obstructive pulmonary disease (COPD) patients, the serum levels of C-reactive protein (CRP) are elevated and an increase of CRP is more exaggerated in the acute exacerbation form of COPD (AECOPD) than in stable COPD. Pulmonary arterial hypertension is a common complication of COPD. An increased level of CRP is known to be associated with the risk of systemic cardio-vascular disorders. However, few findings are available on the potential role of CRP in pulmonary arterial hypertension due to COPD. Methods: This study was performed prospectively and the study population was composed of 72 patients that were hospitalized due to AECOPD. After receiving acute management for AECOPD, serum CRP levels were evaluated, arterial oxygen pressure ($PaO_2$), was measured, and the existence of pulmonary arterial hypertension under room air inhalation was determined in the patients. Results: The number of patients with pulmonary arterial hypertension was 47 (65.3%)., There was an increased prevalence of pulmonary arterial hypertension and an increase of serum CRP levels in patients with the higher stages of COPD (e.g., patients with stage 3 and stage 4 disease; P<0.05). The mean serum CRP levels of patients with pulmonary arterial hypertension and without pulmonary arterial hypertension were $37.6{\pm}7.4mg/L$ and $19.9{\pm}6.6mg/L$, respectively (P<0.05). However, there was no significant difference of the mean values of $PaO_2$ between patients with pulmonary arterial hypertension and without pulmonary arterial hypertension statistically ($77.8{\pm}3.6mmHg$ versus $87.2{\pm}6.0mmHg). Conclusion: We conclude that higher serum levels of CRP can be a sign for pulmonary arterial hypertension in AECOPD patients.

The Influence on Residents' Recognition and Attitude on Their Farm Village Development in a Comprehensive Rural Village Development Project (지역주민의 농촌마을종합개발사업에 대한 인식이 농촌관광개발 인식과 태도에 미치는 영향)

  • Park, Chang-Kyu;Kim, Hye-Young
    • Journal of the Economic Geographical Society of Korea
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    • v.14 no.3
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    • pp.419-436
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    • 2011
  • Korean farm villages are locked in vicious circle, as lots of their problems related to low income and hollow matters are geared and multiply. To get over those problems, various plans to develop Korean farm villages are being pushed ahead. In addition, since the early of 1990s, Korea has been projects to develop settlement zones and culture villages. It has been also preceeding with a comprehensive development project of farm villages and a new vitalizations project, etc. All of these projects aim to reorganize and expand life environments, industrial bases, and convenience and welfare facilities. The existing studies on a comprehensive project to develop farm villages have been focusing on evaluation indexes, problems, investment priorities, etc. But in fact, studies on a comprehensive development project of farm villages are not thoroughgoing enough in aspects of residents' attitude and their recognition on the influence on tourist development. Thus, this study aims to present strategic schemes to allow residents to actively participate in a stage of promoting a comprehensive development project of farm villages, a stage of making the plan, and a stage of the implementation. For this, this study analyzes a comprehensive development project of farm villages and attempts to figure out which influence the tourist development in farm villages has on residents' attitude and recognition resulting from changes in economic, social cultural, and environmental aspects. Especially, this study previously examines what influential factors there exists are and what influences the development of farm villages has on residents. Based on the results from the above analysis, schemes to enable residents to actively a comprehensive development project of farm villages are presented as follows. First, it is necessary to raise our recognition on tourism and tourism development of farm villages. If the main theme of a comprehensive development project of farm villages intends farm village development, it is required to educate residents and let them clearly raise their recognition on tourism, and the effect of the project is guaranteed. Second, it is highly required to make a plan so that we can feel economic effects of revenues through project promotion and positive effects including the expansion of infrastructures and welfare facilities, etc. Third, it is necessary to bring into relief the positive recognition and attitude of a comprehensive development project of farm villages. As for the negative recognition and attitude, it is very important to change negative residents' recognition to the positive direction and to allow them to participate in and to take an interest in the project, so that the project can be effectively promoted.

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Analysis of the Critical Thinking Level of Activity Tasks in Home Economics Textbooks for $7^{th}$ Graders (중학교 1학년 가정교과서 활동과제의 비판적 사고 수준 분석)

  • Lee, Mee-Young;Park, Mi-Jeong;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.22 no.3
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    • pp.19-36
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    • 2010
  • The objective of this study was to measure the critical thinking level of activity tasks included in home economics textbooks published under the 2007 Revised National Curriculum. For this purpose, we sampled 3 kinds of Technology-Home Economics textbooks for 7th graders, selected activity tasks contained in the textbooks, and classified them by type. A total of 93 activity tasks were extracted, and they were analyzed using 9 questions on critical thinking prepared based on Kim Young-jung's '9 Elements and 9 Standards of Critical Thinking.' The results of this study were as follows. First, the total score of the critical thinking level of activity tasks in the home economics textbooks was 66.8, which was not high enough to induce learners' critical thinking. Among the sub-categories of critical thinking, the score was high in order of argumentative thinking(83.9), analytical thinking(78.1), and dialectic thinking(38.3). As in the results, the activity tasks were particularly inadequate for inducing dialectic thinking. Second. in the results of analyzing difference in the critical thinking level according to unit, significant difference was observed among the units. Activity tasks in Units 'Adolescents' Self-management'(77.8), 'Adolescents' Consumption life'(75.2), and 'Adolescents' Sex and Peer Relationship'(71.1) induced critical thinking more effectively than those in other units, but activity tasks in Units 'Clothing and Self-expression' (61. 4), 'Adolescents' Development'(60.0), and 'Adolescents' Nutrition and Meals'(59.6) were inadequate for inducing critical thinking. Third, in the results of analyzing difference in the critical thinking level according to activity task type, the level was high in order of 'Inquiry Activities' (75.7), 'Discussions' (74.6), 'Practical Activities'(65.4), and 'Trials' (50.7), and the differences were significant. That is, among activity task types, 'Inquiry Activities' were most effective in inducing learners' critical thinking and 'Trials' were least effective.

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