• Title/Summary/Keyword: sCRP

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Doctor's and Nurses' Perception and Experiences of DNR (DNR(Do-Not-Resuscitate)에 대한 의사와 간호사의 경험 및 인지도)

  • Han, Sung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.3
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    • pp.255-264
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    • 2005
  • This study is a descriptive research in investigating the perception of doctors and nurses with regard to DNR, and data were collected through survey questionnaires. The period of collecting data was between July 15 and October 30, 2004, distributing 128 questionnaires to 128 participants, and a total of 110 questionnaires from 55 doctors and 55 nurses were collected (86%)among 70 different hospitals. The collected data were analyzed using SAS program to get real number and percentage, and were also analyzed with $X^2$-test. The Study Results are as follows: 1. Respondents who agreed with the necessity of DNR was 97.27%, the reasons of DNR necessity were 59.20% of 'impossibility of recovery in spite of lots of efforts,' and 35.20% of 'for the purpose of choosing a comfortable and dignified death,' and 97.2% of respondents answered that it was necessary to give explanation of DNR to serious case patients, terminal patients and their family. 2. Problems derived from DNR decisions were 44.44% of 'lack of treatment and nursing,' 21.11% of 'guilty conscience about failing to do best efforts,' and 71.57% of CPR implementation right after DNR decision. 3. Reasons of implementing CRP for patients with DNR decision were 50.94% of 'for the presence of family and relatives at the point of patient's death,' 20.76% of 'guardian's change of DNR decision,' and 16.98% of 'no communication for the consent after DNR decision.' 4. With regard to who was to make DNR decision? there was a difference in the opinion between doctors' and nurses' group while the group of doctors chose 'by the consent of the family and the doctor in charge,' and the group of nurses chose 'patient's intension,' and with regard to Have you received DNR related education? and Will people who want DNR increase if there is explanation given? there was a difference between the two groups. 5. In the catholic institutions, respondents of 71.7% said that it was necessary to take DNR depending upon the situation, and 73% said that they had performed DNR before. 6. In the institutions with over 500 beds, 91.92% of respondents said that there should be an establishment of guideline book as a written format to implement DNR. From the results of this study, it was found that DNR was implemented and executed broadly in clinical fields in the absence of necessary instructions and/or guideline, and that DNR order was placed to the group of doctors who got less opportunity for proper education than did that of nurses.

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Seismic interval velocity analysis on prestack depth domain for detecting the bottom simulating reflector of gas-hydrate (가스 하이드레이트 부존층의 하부 경계면을 규명하기 위한 심도영역 탄성파 구간속도 분석)

  • Ko Seung-Won;Chung Bu-Heung
    • 한국신재생에너지학회:학술대회논문집
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    • 2005.06a
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    • pp.638-642
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    • 2005
  • For gas hydrate exploration, long offset multichannel seismic data acquired using by the 4km streamer length in Ulleung basin of the East Sea. The dataset was processed to define the BSRs (Bottom Simulating Reflectors) and to estimate the amount of gas hydrates. Confirmation of the presence of Bottom Simulating reflectors (BSR) and investigation of its physical properties from seismic section are important for gas hydrate detection. Specially, faster interval velocity overlying slower interval velocity indicates the likely presences of gas hydrate above BSR and free gas underneath BSR. In consequence, estimation of correct interval velocities and analysis of their spatial variations are critical processes for gas hydrate detection using seismic reflection data. Using Dix's equation, Root Mean Square (RMS) velocities can be converted into interval velocities. However, it is not a proper way to investigate interval velocities above and below BSR considering the fact that RMS velocities have poor resolution and correctness and the assumption that interval velocities increase along the depth. Therefore, we incorporated Migration Velocity Analysis (MVA) software produced by Landmark CO. to estimate correct interval velocities in detail. MVA is a process to yield velocities of sediments between layers using Common Mid Point (CMP) gathered seismic data. The CMP gathered data for MVA should be produced after basic processing steps to enhance the signal to noise ratio of the first reflections. Prestack depth migrated section is produced using interval velocities and interval velocities are key parameters governing qualities of prestack depth migration section. Correctness of interval velocities can be examined by the presence of Residual Move Out (RMO) on CMP gathered data. If there is no RMO, peaks of primary reflection events are flat in horizontal direction for all offsets of Common Reflection Point (CRP) gathers and it proves that prestack depth migration is done with correct velocity field. Used method in this study, Tomographic inversion needs two initial input data. One is the dataset obtained from the results of preprocessing by removing multiples and noise and stacked partially. The other is the depth domain velocity model build by smoothing and editing the interval velocity converted from RMS velocity. After the three times iteration of tomography inversion, Optimum interval velocity field can be fixed. The conclusion of this study as follow, the final Interval velocity around the BSR decreased to 1400 m/s from 2500 m/s abruptly. BSR is showed about 200m depth under the seabottom

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A Clinical Study of Aseptic Meningitis from 1996 to 1998 (입원 치료한 무균성 뇌막염 환아의 임상적 검토 : 1996년~1998년)

  • Lee, Yong Hee;Kim, Ae Suk
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.168-174
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    • 2001
  • Purpose : There was an epidemic of aseptic meningitis in Korea for 3 years from 1996 to 1998. In this study, we reported the time of outbreak, age and sex distribution, clinical manifestations, laboratory data, and complications of the children with aseptic meningitis. Methods : We reviewed clinical records of 192 aseptic meningitis patients who had been admitted to Pohang St. Mary's Hospital from 1996 to 1998. Results : Aseptic meningitis occurred most frequently in July and August. The ratio of male to female was 1.91 : 1, and the most prevalent age was 1 to 5 years of age. The main symptoms were fever, vomiting, headache in this order of frequency. Peripheral blood showed leukocytosis(WBC > $10,000/mm^3$) in 44.3% of the cases. CSF examination showed WBC count were less than $500/mm^3$ in 88.0%, protein levels less than 40 mg/dL in 61.5%, and glucose levels more than 40 mg/dL in 94.3% of the cases. We did not isolate the causative viral agents. Conclusion : Aseptic meningitis was prevalent in children in the Pohang area from 1996 to 1998. Clinical manifestations and CSF profiles of aseptic meningitis patients showed no great difference compared to other reported.

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A Clinical Study of Aseptic Meningitis in the Busan Area in 2002 (2002년 부산 지역에서 유행한 무균성 뇌막염에 대한 임상적 고찰)

  • Park, Ji Hyun;Lee, Na Young;Kim, Gil Hyun;Jung, Jin Hwa;Cho, Kyung Soon;Kim, Sung Mi
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.858-864
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    • 2003
  • Purpose : There was a outbreak of aseptic meningitis in Busan, 2002. We report the clinical features and causative viruses. Methods : Two hundred seventy six children with aseptic meningitis who were admitted to the Department of Pediatrics, Maryknoll Hospital between January and December, 2002 were included. CSF, stool and throat swab viral cultures were done in 244 of these children. Results : The male to female ratio was 1.4 : 1. Age of patients varied from five months to fourteen years old. Average age was $5.7{\pm}6.2years$ old and mostly between one and four years.(41.3%) Monthly distribution revealed that the number of patients increased from May to July. The main symptoms were fever, headache and vomiting in this order. Respiratory tract infection symptom was associated from June to July and headache and nausea without fever were characteristically observed in children more than 10 years old from November to December. In peripheral blood examination, leukocytosis(WBC>$10,000/mm^3$) showed in 34.8%, ESR was increased in 56.1%, and CRP was positive value in 61%. Therefore differential diagnosis was difficult through peripheral blood examination. CSF findings revealed mean leukocyte count $86.5{\pm}180.2/mm^3$, protein $41.7{\pm}32.9mg/dL$, glucose $56.4{\pm}9.9mg/dL$. Median hospitalized period was $4.7{\pm}7.2days$ and compared with non-tapping group, hospitalized period was shorter and subsidance of symptoms was faster, therefore antibiotics injection period was shorter in the spinal tapping group. Virus was isolated in 31 cases of 244. The causative agents were echovirus 6, echovirus 9, echovirus 25, coxsakie virus B3, B4. Conclusion : There was an epidemics of aseptic meningitis in Busan, 2002; the causative agent was echovirus 6, 9, 25, coxsakie virus B3, B4.

Predicting the Concentration of Obesity-related Metabolites via Heart Rate Variability for Korean Premenopausal Obese Women: Multiple Regression Analysis (심박변이도를 통한 폐경 전 한국인 비만 여성의 비만 관련 대사체 농도 예측을 위한 회귀분석)

  • Kim, Jongyeon;Yang, Yo-Chan;Yi, Woon-Sup;Kim, Je-In;Maeng, Tae-Ho;Yoo, Duk-Joo;Shim, Jae-Woo;Cho, Woo-Young;Song, Mi-Yeon;Lee, Jong-Soo
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.155-162
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    • 2014
  • Objectives Advanced researches on the relationship between obesity and heart rate variability (HRV), heretofore, focused on characteristics of HRV depending on the state of obesity. However, the previous researches have not quantified predictive power of HRV toward the obesity-related variables, which is rather more meaningful for clinicians who regularly treat obese patients. Hence, we designed a research to investigate whether HRV could predict serum levels of obesity-related metabolites. Methods Ninety obese premenopausal women meeting the inclusion criteria were recruited. The HRV test, blood sampling, and measurement of physical traits were conducted. Multiple regression analysis of the measurement data was carried out, putting obesity-related metabolites (insulin, glucose, triglyceride, hs-CRP, HDL, LDL, total cholesterol) as outcome variables and the others as predictors. To select appropriate predictive variables, the Akaike's Information Criterion (AIC) was applied. Normality and homoskedasticity of residuals for each model were tested to identify if there were any violations of the regression analysis's basic assumption. Logarithm transformation was used for the values of the concentration of metabolites and the HRV. Results The regression model including Total Power (TP) value and BMI had significant predictive power for serum insulin concentration (F(2, 88)=835.7, p<0.001, $R^2=0.95$). The regression coefficient of ln (TP) was -0.1002. However, it was not sure if the HRV could predict concentrations of other metabolites. Conclusions The results suggest that the Total Power (TP) value of the HRV can predict the level of serum insulin. If the BMI could be assumed as being constant, when the TP value is multiplied by n, the predicted change of insulin could be drawn by multiplying $n^{-0.1002}$. The uncertainty of this model can be assumed as approximately 5%.

Smoking Habits and Neuropeptides: Adiponectin, Brain-derived Neurotrophic Factor, and Leptin Levels

  • Kim, Ki-Woong;Won, Yong Lim;Ko, Kyung Sun;Roh, Ji Won
    • Toxicological Research
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    • v.30 no.2
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    • pp.91-97
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    • 2014
  • This study aimed to identify changes in the level of neuropeptides among current smokers, former smokers, and individuals who had never smoked, and how smoking habits affect obesity and metabolic syndrome (MetS). Neuropeptide levels, anthropometric parameters, and metabolic syndrome diagnostic indices were determined among male workers; 117 of these had never smoked, whereas 58 and 198 were former and current smokers, respectively. The total sample comprised 373 male workers. The results obtained from anthropometric measurements showed that current smokers attained significantly lower body weight, body mass index, waist circumference, and abdominal fat thickness values than former smokers and those who had never smoked. Current smokers' eating habits proved worse than those of non-smokers and individuals who had never smoked. The level of brain-derived neurotrophic factor (BDNF) in the neuropeptides in the case of former smokers was $23.6{\pm}9.2pg/ml$, higher than that of current smokers ($20.4{\pm}6.1$) and individuals who had never smoked ($22.4{\pm}5.8$) (F = 6.520, p = 0.002). The level of adiponectin among former smokers was somewhat lower than that of current smokers, whereas leptin levels were higher among former smokers than current smokers; these results were not statistically significant. A relationship was found between adiponectin and triglyceride among non-smokers (odds ratio = 0.660, ${\beta}$ value=-0.416, p < 0.01) and smokers (odds ratio = 0.827, ${\beta}$ value=-0.190, p < 0.05). Further, waist circumference among non-smokers (odds ratio = 1.622, ${\beta}$ value=0.483, p < 0.001) and smokers (odds ratio = 1.895, ${\beta}$ value=0.639, p < 0.001) was associated with leptin. It was concluded that cigarette smoking leads to an imbalance of energy expenditure and appetite by changing the concentration of neuropeptides such as adiponectin, BDNF, leptin, and hsCRP, and influences food intake, body weight, the body mass index, blood pressure, and abdominal fat, which are risk factors for MetS and cardiovascular disease.

Effects of feed intake restriction during late pregnancy on the function, anti-oxidation capability and acute phase protein synthesis of ovine liver

  • Yang, Huan;Wang, Ying;Ma, Chi;Sun, Chuan;Liu, Yingchun;Wu, Kaifeng;Li, Ming;Borjigin, Gerelt;Gao, Feng
    • Asian-Australasian Journal of Animal Sciences
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    • v.32 no.2
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    • pp.217-223
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    • 2019
  • Objective: An experiment was conducted to investigate the effects of feed intake restriction during late pregnancy on the function, anti-oxidation capability and acute phase protein synthesis of ovine liver. Methods: Eighteen time-mated ewes with singleton fetuses were allocated to three groups: restricted group 1 (RG1, 0.18 MJ ME/kg $W^{0.75}$ d, n = 6), restricted group 2 (RG2, 0.33 MJ ME/kg $W^{0.75}$ d), n = 6) and a control group (CG, ad libitum, 0.67 MJ ME/kg $W^{0.75}$ d, n = 6). The feed restriction period was from 90 days to 140 days of pregnancy. Results: The ewe's body weight, liver weights, water, and protein content of liver in the restricted groups were reduced compared with the CG group (p<0.05), but the liver fat contents in the RG1 group were higher than those of the CG group (p<0.05). The increased hepatic collagen fibers and reticular fibers were observed in the restricted groups with the reduction of energy intake. The concentrations of nonesterified free fatty acids in the RG1 and RG2 groups were higher than those of the CG group with the reduction of energy intake (p<0.05), but there were decreased concentrations of lipoprotein lipase and hepatic lipase in both restricted groups compared with the CG group (p<0.05). In addition, the increased concentrations of ${\beta}$-hydroxybutyric acid, triglycerides, malondialdehyde, total antioxidant capacity and activities of superoxide dismutase activity and catalase were found in the RG1 group, and the concentrations of cholinesterase in the RG1 group were reduced compared with the CG group (p<0.05). For the concentrations of acute phase proteins, the C-reactive protein (CRP) in the RG1 group were reduced compared with the CG group, but there were no differences in haptoglobin relative to the controls (p>0.05). Conclusion: The fat accumulation, increased hepatic fibrosis, antioxidant imbalance and modified synthesis of acute phase proteins were induced in ewe's liver by maternal malnutrition during late pregnancy, which were detrimental for liver function to accommodate pregnancy.

Intercomparisonn of Techniques for Pressure Tube Inspection of Pressurized heavy Water Reactor (가압 중수로형 원자력발전소 압력관 비파괴검사기술의 상호비교)

  • Lee, Hee-Jong;Kim, Yong-Si;Yoon, Byung-Sik;Lee, Young-Ho
    • Journal of the Korean Society for Nondestructive Testing
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    • v.25 no.4
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    • pp.294-303
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    • 2005
  • This paper describes the analysis results of a series f Round-Robin test that was performed to intercompare inspection and diagnosis techniques for characterization of pressure tube f a pressurized heavy water reactor under the Coordinated Research Project(CRP) of IAEA's nuclear Power Programme. For this test, six nations, Korea, Canada, India, Argentina, Rumania, and China that currently have pressurized heavy water reactors under operation involved, and the "KOR-1" pressure tube sample prepared by Korea was used. Two kinds of NDE technique, ultrasonic and eddy current test, were applied for these tests. The "KOR-1" pressure tube sample contains total 12 artificial flaws such as crack-like EDM notches, wear that is similar to the real flaws and can be produced on the pressure tubes during plant operation. Test results showed that seven laboratories from six nations detected all twelve flaws in "KOR-1" specimen by using ultrasonic and eddy current test methods, and ultrasonic test method was more accurate than eddy current test method in flaw detectin and sizing. ID flaws in pressure tube sample were more easily detected and accurately sized than OD flaws.

Prediction of Patient Discharge Status Based on Indicators on Admission (입원 초기 지표를 통한 호스피스 환자의 퇴원 형태 예측)

  • Chung, Sung-In;Lee, Seung Hun;Kim, Yun-Jin;Lee, Sang-Yeoup;Lee, Jeong-Gyu;Yi, Yu-Hyeon;Cho, Young-Hye;Tak, Young-Jin;Hwang, Hye-Rim;Park, Eun-Ju;Kim, Kyung-Mi
    • Journal of Hospice and Palliative Care
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    • v.21 no.3
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    • pp.75-83
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    • 2018
  • Purpose: To provide effective palliative care, it is important to predict not only patients' life expectancy but their discharge status at a time of inpatient admission to a hospice care facility. This study was aimed to identify meaningful life expectancy indicators that can be used to predict patients' discharge status on admission to the facility. Methods: Among 568 patients who were admitted to the hospice ward of P hospital from April 1, 2016 through December 31, 2017, 377 terminal cancer patients were selected. This retrospective cohort study was performed by using performance status, symptoms and signs, socioeconomic status, laboratory findings on admission. Results: Alive discharge was associated with a good performance status that was measured with the Karnofsky and Eastern Cooperative Oncology Group (ECOG) scales and the Global health and Mental status. Less anorexia, dyspnea, dysphagia and fatigue were also associated with symptoms and signs. Associated laboratory findings were close to normal Complete Blood Cell (CBC) count, Liver Function Test (LFT) and Blood Urea Nitrogen (BUN). Conclusion: Our findings suggest that Karnofsky Performance Status (KPS), ECOG, Global health, Mental status, anorexia, dyspnea, dysphagia, fatigue, CBC, LFT, BUN are meaningful indicators when predicting discharge status for inpatients. Further investigation is warranted.

Serum and Cerebrospinal Fluid(CSF) Nitric Oxide, Macrophage Inflammatory Protein-1 α and Lactoferrin Levels in Aseptic Meningitis (무균성 뇌수막염 환자의 뇌척수액과 혈청에서 Nitric Oxide, Macrophage Inflammatory Protein(MIP)-1α, Lactoferrin 값의 비교)

  • Seo, Young;Sim, Jung Yeon;Shim, Jae Won;Kim, Deok Su;Jung, Hye Lim;Park, Moon Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.48-54
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    • 2005
  • Purpose : The pathologic mechanisms of central nervous system(CNS) injuries in human meningitis are not yet completely understood. Recent studies indicate that the host inflammatory responses are as important in brain damage as the infecting organisms and toxins. There have been some reports on the relationship of nitric oxide(NO), macrophage inflammatory protein-$1{\alpha}$(MIP-$1{\alpha}$), and lactoferrin in bacterial meningitis, but few reports in aseptic meningitis. Thus, we investigated the concentrations of NO, MIP-$1{\alpha}$ and lactoferrin in cerebrospinal fluid(CSF) and serum of patients with aseptic meningitis and control subjects and evaluated their relationship with other parameters of meningitis. Methods : CSF and blood were obtained from 25 subjects with aseptic meningitis and 15 control subjects. After centrifugation, supernatants were stored at $-70^{\circ}C$ and we assayed the concentrations of NO, MIP-$1{\alpha}$ and lactoferrin with the ELISA method. There were no patients with neurologic sequelae after being recovered from aseptic meningitis. Results : Concentrations of CSF and serum NO, MIP-$1{\alpha}$ were not increased in aseptic meningitis subjects compared to control subjects. Concentration of CSF lactoferrin was significantly elevated in patients with aseptic meningitis and concentration of serum lactoferrin was significantly decreased in patients with aseptic meningitis compared with those in control subjects(P<0.05). CSF lactoferrin level was positively correlated with CSF WBC counts($r_s=0.449$, P=0.007), especially with neutrophil counts($r_s=0.574$, P<0.001) and CSF protein level($r_s=0.508$, P=0.002). Conclusion : Lactoferrin plays an important role in aseptic meningitis and may be released from neutrophils recruited from blood to the CSF through breakdown of blood-brain barrier. NO and MIP-$1{\alpha}$ may not be important factors in the pathogenesis of aseptic meningitis without neurologic sequelae.