Background: Although the prevalence of pulmonary tuberculosis has progressively decreased all over the world, drug-resistant tuberculosis is major obstacle in treating tuberculosis. This study was performed to examine the current prevalence and risk factors of drug resistant tuberculosis in a single tertiary hospital in Busan, Korea. Methods: We enrolled 367 patients with active pulmonary tuberculosis on a retrospective basis who had undergone mycobacterium culture and drug sensitivity tests between January 2005 and December 2009. We analyzed all clinical and radiographic parameters to find predictors related to drug resistant tuberculosis. Results: At least one incident of drug resistance was found in 75 (20.4%) patients. Isoniazid (18.8%) was the most frequent resistant drug, followed by rifampin (10.9%), ethambutol (7.1%), streptomycin (4.9%), and fluoroquinolone (2.7%). Resistance to second-line drugs was found in 37 (10.1%) patients. Multidrug resistance and extensively drug resistance was evident in 39 (10.6%) and 4 (1.1%) patients, respectively. Using multiple logistic regression analysis, history of previous treatment including relapse (odd ratio [OR], 11.3; 95% confidence interval [CI], 4.92~26.08; p<0.01), treatment failure (OR, 24.1; 95% CI, 5.65~102.79; p<0.01) and an age of below 46 years-old (OR, 3.8; 95% CI, 1.62~8.65; p<0.01) were found to be independent predictors of multidrug resistant tuberculosis. Conclusion: We found that the prevalence of drug resistant tuberculosis was considerably high. A careful consideration for possible drug resistant tuberculosis is warranted in patients with a history of previous treatment or for younger patients.
We test a model of investment-cashflow-growth opportunities relationship in order to estimate the sensitivities to investments. In this study, we use a new proxy variable for the value of growth opportunities(hereafter "VGO"), which is based on the seminal papers of M&M(1958:1961:1963) and Lee(2006;2007). The empirical findings on the sensitivities of cashflow and growth opportunities are as follows. First, when the traditional proxy variables for the growth opportunities such as Tobin's Q, MBR and sales growth are included with the new proxy VGO in the estimation, their coefficients are turned out to be insignificant. Second, only the new proxy variable VGO shows a statistically significant positive sensitibity to investment, which can be regarded that the growth opportunities hold the positive influences to investments. Third, the Tobin's Q can be decomposed into three factors such as the value of growth opportunities(VGO), the value of asset-in-place and valuation errors. It turns out that only the VGO shows a statistically significant positive relationship with investment among others. This means that the new variable VGO is a good proxy variable for the growth opportunities in the investment-cashflow sensitivity analysis. In sum, thanks to the above findings in this study, we can say that it will not be proper to choose a proxy variable for the growth opportunities from the traditional set of proxies such as Tobin's Q, MBR, or sales growth rate.
KSCE Journal of Civil and Environmental Engineering Research
/
v.13
no.2
/
pp.95-109
/
1993
In this study, the optimal configuration of arch structure has been tested by a decomposition technique. The object of this study is to provide the method of optimizing the shapes of both two hinged and fixed arches. The problem of optimal configuration of arch structures includes the interaction formulas, the working stress, and the buckling stress constraints on the assumption that arch ribs can be approximated by a finite number of straight members. On the first level, buckling loads are calculated from the relation of the stiffness matrix and the geometric stiffness matrix by using Rayleigh-Ritz method, and the number of the structural analyses can be decreased by approximating member forces through sensitivity analysis using the design space approach. The objective function is formulated as the total weight of the structures, and the constraints are derived by including the working stress, the buckling stress, and the side limit. On the second level, the nodal point coordinates of the arch structures are used as design variables and the objective function has been taken as the weight function. By treating the nodal point coordinates as design variable, the problem of optimization can be reduced to unconstrained optimal design problem which is easy to solve. Numerical comparisons with results which are obtained from numerical tests for several arch structures with various shapes and constraints show that convergence rate is very fast regardless of constraint types and configuration of arch structures. And the optimal configuration or the arch structures obtained in this study is almost the identical one from other results. The total weight could be decreased by 17.7%-91.7% when an optimal configuration is accomplished.
Purpose : The efficacy of magnetic resonance imaging for evaluating coronary artery disease has been reported. In this study, we evaluated the usefulness of breath-hold segmented K-space cine MR imaging for evaluating the patency of coronary artery bypass grafts (CABG). Materials and Method s : Thirty eight patients with a total of 92 CABGs (36 internal thoracic arteries and 56 saphenous vein grafts) were evaluated using segmented K-space cardiac-gated fast gradient echo sequence (2D-FASTCARD) MR imaging. MR magnitude images were evaluated from the hard copies by two independent observers. A graft was defined as patent if it was seen as a bright small round area on at least two consecutive images throughout the cardiac cycle at a position consistent with the expected location for that graft. Results : MR images were obtained successfully for 23 patients (61%). The sagittal planes were most helpful in visualizing the cross-section of sapheneous vein bypass graft to left circumflex artery branch, whereas the transverse planes were used for identification of internal mammary artery grafts to left anterior descending coronary artery or its branch and identification of saphenous vein grafts to right coronary artery. Forty five grafts were visible using this MR technique, while the grafts were not visible on seven saphenous vein grafts and two internal mammary artery grafts. In two patients showing symptoms of myocardial ischemia, one or two bypass grafts were not visible. Imaging, perpendicular plane to a CABG was important to visualize the flow inside the CABG with maximum sensitivity. Conclusion : Evaluation of patency of the bypass graft was clinically feasible by 2D-FASTCARD MR imaging, whereas any invisible bypass grafts should be further studied by contrast-enhanced MR angiography or by conventional angiography for confirmation of abnormalities.
This study is an empirical analysis on Moderating Effect of Government support on Relationship between Social Entrepreneurship and Organizational Performance. Previous studies have focused on case studies for specific companies and studies on Social entrepreneurship have been carried out in recent years. As the interest in social enterprises is increasing due to the problem of social polarization, it is necessary to study the causal relationship between social entrepreneurship and organizational performance deeply, and the government continues to provide government support for social enterprises. However, there is a lack of research on the effects of government support on social entrepreneurship and organizational performance. Therefore, this study analyzes the Proactiveness and Risk-taking of social entrepreneurship and examines the causal relationship between the organization's economic performance and social performance and the moderating effect of government support on the members of the social enterprise in Chungcheong area based on the previous research It is expected that the researcher will give academic and practical value to practitioners. As a result of this study, it is shown that the risk sensitivity of social entrepreneurship has a significant effect on the economic performance, and the Proactiveness of entrepreneurship and Risk-taking of social entrepreneurship all have a positive effect on the social performance, The results of the study show that government support has only a positive effect on the moderating effects of the variables of enterprising and social performance among the variables. The results of this study suggest that social entrepreneurship in social enterprises is an important factor affecting organizational performance. Therefore, if managers of social enterprises continue to educate and apply social entrepreneurship to their members, The social and economic performance of social enterprises will increase, which will help to enhance the competitiveness of enterprises. In addition, although the government has implemented various policies to support social enterprises, there is no expectation of government support for organizational performance because of the lack of support from the government after social enterprise certification. And to develop the government's fine - tuned upbringing policy that can improve organizational performance.
Background: The purpose of this study was to determine whether hand-measured carotid intima-media thickness (IMT) was a reliable and simple tool that could be used to evaluate the severity of stable coronary artery disease (CAD) with normal high-sensitivity C-reactive protein (CRP). Material and Method: We examined left carotid IMTs in 688 patients with stable CAD and excluded 121 patients with abnormally elevated hs-CRP ($\geq$0.5 mg/dL). We sought to determine the association between risk factors and the severity of stable CAD and carotid IMT in 567 patients who were divided into lower and higher groups based on the median value. Patients underwent a coronary artery angiogram and had at least significant stenosis (>50% of the original luminal diameter involving one or more major coronary artery). Result: Of the 567 patients, 300 (52.9%) were in the lower IMT group and 267 (47.1%) were in the higher IMT group; the median value was 0.76 mm. By multivariable logistic regression analysis, the following groups were different: older age (~49 vs. 70~ years, respectively; OR=6.552), high FBS (~99 vs. 120~ mg/dL; OR=1.713) and severity of CAD (1 vessel vs. 2 vessel disease; OR=1.711, 1 vessel vs. 3 vessel disease; OR=1.714). Conclusion: We conclude that there are correlations between increased carotid IMT and severity of CAD in stable angina patients with normal CRP levels.
This paper is a result from validation study for SPDA(A Screening Scale For Potential Drug-use Adolescents) created in 2003 and newly developed during 2004. SPDA aims to screen adolescents in their early stage of drug-use and to help practitioners make a preventive approach for the adolescents. 4307 junior and senior high school students were selected as primary research subjects by stratified and quota sampling methods. 305 adolescents on probation were also selected as a comparison group and asked to answer the same questionnaire. Reliability for SPDA recorded 0.914, which proved to be better than previous year's (0.898). Exploratory and confirmatory factor analyses to test construct validity proved that SPDA could be divided into 7 factors and that each factor structure of SPDA could be a proper measurement model with high level of fitness and factor loadings. Discriminant analysis to test predictive validity confirmed that SPDA could classify the adolescents excellently by the frequency of drug-use, with hit ratio of 86.6 percent(78.8% and 87.4% for junior and senior high school students respectively). For concurrent validity test, Hare Home Self-Esteem Scale, Hare School Self-Esteem, Zuckerman-Kuhlman Sensation-seeking Scale were employed to find correlation with SPDA and all the three scales had significant Pearson correlation coefficients with SPDA. Known-groups validity test indicated that SPDA had an adequate power to classify out adolescents on probation from those in schooling, with a hit ratio of 71.8 percent. Cut-off point to detect adolescents with high risk of substance use was 77, which indicated approximately T score, 55 (0.5 SD), satisfying sensitivity, specificity, and efficiency criteria.
Malnutrition of hospitalized patients can adversely affect clinical outcomes and cost. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those possess practical pitfalls of requiring much time and labor to administer and may not be highly applicable to a Korean population. This study sought to develop and evaluate a Nutrition Risk Screening Tool (NRST) which is simple and quick to administer and widely applicable to Korean hospitalized patients with various diseases. The study was also designed to generate a screening tool predictable of various clinical outcomes and to validate it against the Nutritional Risk Screening 2002 (NRS 2002). Electronic medical records of 424 patients hospitalized at a general hospital in Seoul during a 14-month period were abstracted for anthropometric, medical, biochemical, and clinical outcome variables. The study employed a 4-step process consisting of selecting NRST components, searching a scoring scheme, validating against a reference tool, and confirming clinical outcome predictability. NRST components were selected by stepwise multiple regression analysis of each clinical outcome (i.e., hospitalization period, complication, disease progress, and death) on several readily available patient characteristics. Age and serum levels of albumin, hematocrit (Hct), and total lymphocyte count (TLC) remained in the last model for any of 4 dependent variables were decided as NRST components. Odds ratios of malnutrition risk based on NRS 2002 according to levels of the selected components were utilized to frame a scoring scheme of NRST. A NRST score higher than 3.5 was set as a cut-off score for malnutrition risk based on sensitivity and specificity levels against NRS 2002. Lastly differences in clinical outcomes by patients' NRST results were examined. The results showed that the NRST can significantly predict the in-hospital clinical outcomes. It is concluded that the NRST can be useful to simply and quickly screen patients at high-nutritional risk in relation to prospective clinical outcomes.
Journal of the Korean Institute of Landscape Architecture
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v.40
no.6
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pp.173-179
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2012
The experiments, which analyze the injury symptoms and diagnose growth conditions utilizing IRVT and analyzing each parts of H. helix L., had been held under a low temperature. Greenhouse and outdoor growing Genus hedera had been prepared and compared with each Genus hedera's peak and bottom leaves' surface temperature under the experimental categories $-6^{\circ}C$ and $-12^{\circ}C$. As results, analyzing the surface thermal property of peak part leaves' of outdoor growing Genus hedera, at experimental categories $-6^{\circ}C$, $-12^{\circ}C$ were ranged from $-2^{\circ}C{\sim}-7^{\circ}C$ and $-2^{\circ}C{\sim}-15^{\circ}C$. On the other hand, the surface thermal property of bottom part leaves at experimental categories $-6^{\circ}C$, $-12^{\circ}C$ were ranged $-2^{\circ}C{\sim}-11^{\circ}C$ and $-1^{\circ}C{\sim}-12^{\circ}C$. It appears that the thermal properties of leaves' surface on $-6^{\circ}C$ peaks and $-12^{\circ}C$ bottoms were more broadband than bottoms and peaks. It means that the peaks were more sensitive than bottoms, as like $-2^{\circ}C{\sim}-15^{\circ}C$, $-1{\sim}-12^{\circ}C$. Moreover, as similar results had seen to leaves surface temperature added to cold wind conditions. How the cold wind damaged the outdoor growing Genus hedera, analyzed the surface thermal property by IRVT data under $0^{\circ}C$, $-2^{\circ}C$, $-4^{\circ}C$ condition, it resulted to $-6.2^{\circ}C$, $-6.8^{\circ}C$, $-7.5^{\circ}C$. It appeared more $3.5{\sim}6.2^{\circ}C$ low temperature than experimental setting point. In addition, each parts thurmal property of peaks and bottoms was not similar, it referred to each parts' sensitivities of low temperature were different on the peak and bottom leaves surface temperature.
Purpose : This study aimed to determine the best cutoff line for insulin-like growth factor (IGF)-I and insulin-like growth factor binding protein (IGFBP)-3 to discriminate between growth hormone deficiency (GHD) patients and the control group. Methods : Two hundred thirty subjects with normal controls (129 boys and 101 girls, aged 7-15 years), 14 patients with complete GHD (12 boys and 2 girls), and 17 patients with partial GHD (9 boys and 8 girls) were studied. IGF-I serum concentrations were measured by radioimmunoassay (RI), and IGFBP-3 concentrations were measured by immunoradiometric assay (IRMA). Results : The receiver operating characteristic (ROC) plot analysis showed that the best IGF-I and IGFBP-3 cutoff line was at -1 standard deviation (SD). By comparing IGF-I serum levels of GHD children within 1 SD of normal control, we determined the sensitivity (S) (87.5-100%) and specificity (Sp) (80-84.6%) according to the age group. For IGFBP-3, we determined the following values: S (58.7-85.7%) and Sp (79.2-85.5%). Eleven of 14 patients with complete GHD (78.5%) and 16 of 17 patients with partial GHD (94.1%) had IGF-I concentrations equal to or below -1 SD of the control group mean. Ten of 12 complete GHD children (83.3%) and 13 of 17 partial GHD children (76.5%) had IGFBP-3 concentrations equal or below -1 SD of the control group mean. Conclusion : We conclude that the measurement of IGF-I and IGFBP-3 concentrations might provide essential supplementary data in the diagnostic evaluation of patients with GHD. Our results support the need to use cutoff lines based on below -1 SD of the control.
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