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Clinical review of Typhoid Fever Patients (장티브스에 관한 임상적 관찰)

  • 최정신
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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Velocity-effective stress response of $CO_2$-saturated sandstones ($CO_2$로 포화된 사암의 속도-유효응력 반응)

  • Siggins, Anthony F.
    • Geophysics and Geophysical Exploration
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    • v.9 no.1
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    • pp.60-66
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    • 2006
  • Three differing sandstones, two synthetic and one field sample, have been tested ultrasonically under a range of confining pressures and pore pressures representative of in-situ reservoir pressures. These sandstones include: a synthetic sandstone with calcite intergranular cement produced using the CSIRO Calcite In-situ Precipitation Process (CIPS); a synthetic sandstone with silica intergranular cement; and a core sample from the Otway Basin Waarre Formation, Boggy Creek 1 well, from the target lithology for a trial $CO_2$ pilot project. Initial testing was carried on the cores at "room-dried" conditions, with confining pressures up to 65 MPa in steps of 5 MPa. All cores were then flooded with $CO_2$, initially in the gas phase at 6 MPa, $22^{\circ}C$, then with liquid-phase $CO_2$ at a temperature of $22^{\circ}C$ and pressures from 7 MPa to 17 MPa in steps of 5 MPa. Confining pressures varied from 10 MPa to 65 MPa. Ultrasonic waveforms for both P- and S-waves were recorded at each effective pressure increment. Velocity versus effective pressure responses were calculated from the experimental data for both P- and S-waves. Attenuations $(1/Q_p)$ were calculated from the waveform data using spectral ratio methods. Theoretical calculations of velocity as a function of effective pressure for each sandstone were made using the $CO_2$ pressure-density and $CO_2$ bulk modulus-pressure phase diagrams and Gassmann effective medium theory. Flooding the cores with gaseous phase $CO_2$ produced negligible change in velocity-effective stress relationships compared to the dry state (air saturated). Flooding with liquid-phase $CO_2$ at various pore pressures lowered velocities by approximately 8% on average compared to the air-saturated state. Attenuations increased with liquid-phase $CO_2$ flooding compared to the air-saturated case. Experimental data agreed with the Gassmann calculations at high effective pressures. The "critical" effective pressure, at which agreement with theory occurred, varied with sandstone type. Discrepancies are thought to be due to differing micro-crack populations in the microstructure of each sandstone type. The agreement with theory at high effective pressures is significant and gives some confidence in predicting seismic behaviour under field conditions when $CO_2$ is injected.

Root Morphology of Norway Spruce (Picea abies [L.] Karst.) in the Differently Acidified Forest Soils (토양(土壤) 산성화(酸性化) 정도(程度)에 따른 독일가문비나무(Picea abies [L.] Karst.))

  • Lee, Do-Hyung
    • Journal of Korean Society of Forest Science
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    • v.89 no.5
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    • pp.677-684
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    • 2000
  • This study was conducted to investigate the relationship of development of root and soil condition and also to elucidate the difference between stands for mechanical and physical stability according to distribution of roots in the Norway Spruce (Picea abies [L.] Karst.) stands of 30 to 40 year of ages with different soil condition. In the root structure, remarkably different root pattern was shown among the three stands; Eberg$\ddot{o}$tzen stand showed large number f roots with much fine roots which deeply in vertical direction while Barbis stands had thicker root and small number of root than Eberg$\ddot{o}$tzen stand. The Weidenbrunnen stand showed differently half-vertical and plate root structure and the root developed not to be deeply compared to the other two stands. In the total number of root, Eberg$\ddot{o}$tzen stand had the most number of 74 and Barbis stand 33, Weidenbrunnen stand 57 respectively. Eberg$\ddot{o}$tzen stand had much more number of vertical root with 57 than the other two stand; Barbis 21 and Weidenbrunnen 36. In the total length of root, Weidenbrunnen stand showed to be longer than the other two stands and the length of horizontal root also showed longer. Regarding to the rates of horizontal root against vertical root, Eberg$\ddot{o}$tzen stand showed comparatively higher value as 1,2 than other two stands(0.5). In the total weight of root, Weidenbrunnen stand showed very high value compared with the other stands and ratio of vertical root against horizontal root was 0,16 which is very lower than the other two stands(0,4). The remarkable differences of root pattern of Norway spruce stands appeared in this study are through to be caused more by chemical property of soil such as acidity den the mechanical or physical factor of soil conditions.

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Mono-Rifampicin-Resistant Pulmonary Tuberculosis (Rifampicin단독내성 폐결핵)

  • Shim, Tae-Sun;Lee, Ki-Man;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.618-627
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    • 1999
  • Background : Rifampicin (RFP) is a key component of the antituberculous short-course chemotherapy. Usually the RFP resistant M.tuberculosis is also resistant to isoniazid (INH), so the RFP resistance is the marker of multi-drug resistant (MDR) tuberculosis. But unusual cases of mono-RFP-resistant tuberculosis have been recently reported with increasing frequency, especially associated with HIV infection in western countries. Therefore, we conducted a retrospective study to investigate the frequency, causes, and the clinical characteristics of mono-RFP-resistant tuberculosis in Korea. Methods : Of the bacteriologically confirmed and susceptibility-proven 699 pulmonary tuberculosis patients (921 isolates) who visited Asan Medical Center from January 1990 to August 1997, eighteen patients with INH-susceptible and RFP-resistant tuberculosis were evaluated. Previous history of tuberculosis, antituberculous drug compliances, associated systemic illness, drug susceptibility patterns, and clinical outcomes were analysed. And rpoB gene sequencing was done in 6 clinical isolates of M. tuberculosis. Results : The mean age of 18 patients was $43{\pm}14$ years, and the sex ratio is 12:6 (M : F). Sixteen (89%) patients had previous history of tuberculosis. None had diagnosed gastrointestinal disorders, and 2 HIV tests that were performed came out negative. Susceptibility tests were done repeatedly in eleven patients, and six (55%) were mono-RFP resistant repeatedly while five (45%) evolved to MDR tuberculosis. Eight (44%) patients were cured, six (33%) failed, three (17%) were lost to follow-up, and the other one is now on treatment. rpoB gene sequencing showed 5 mutations, codon 531 TCG to TIG mutation in 4 isolates and 526 CAC to TAC in 1 isolate. Conclusion : The clinical characteristics of mono-RFP resistant tuberculosis were similar to that of MDR tuberculosis in Korea where the HIV infection rate is lower than western countries. But some patients with mono-RFP-resistant tuberculous could be cured by primary drug regimens including RFP, suggesting that mono-RFP-resistant tuberculous is a different entity from MDR tuberculosis.

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Effect of complex fertilizer treatment on a recovery of reduced turfgrass caused by competing with trees in golf course (복합비료 시비가 골프코스 수목근부 잔디고사 회복에 미치는 영향)

  • Jang Duk-Hwan;Kim Ho-Jun;Lee Tea-Wu;Kim Gun-Wu
    • Asian Journal of Turfgrass Science
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    • v.19 no.1
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    • pp.1-16
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    • 2005
  • This study was conducted to effect a complex fertilizer treatment on a recovery of damaged turfgrass caused by competing with tree at area under trees, and to seek for effective management system on damaged areas under trees in golf courses. Available phosphorous and potassium were enough to grow up turfgrass in plots of East valley and Ji San Golf Club. But these plots were acid soil ranged from pH 5.3 to pH 5.5, so that lime fertilizer was required for improving the chemical of soil. The effect on complex fertilizer showed significant f3r the recovery of damaged turfgrass. Turfgrass recovery ratio by complex fertilizer was better in low-density(LD) section of fertilizer than in high-density(HD) section of control. As the result of surveying turfgrass characters according to dates, dry matters in HD sections of control plots were higher than these in LD sections of fertilizer plots in 6 Aug. before sprinkling a complex fertilizer. But dry matters in LD section of fertilizer were, on the contrary, higher than in 6 Sep. after sprinkling complex fertilizer. In view of the result so far conducted, a turfgrass recovery to LD sections of complex fertilizer was batter than that of HD sections of control. Sprinkling complex fertilizer on turfgrass damaged by competing with trees will maintain the turfgrass growth, even though happen to compete between trees and turfgrass.

Favorable Outcome in Elderly Asian Patients with Metastatic Renal Cell Carcinoma Treated with Everolimus: The Osaka Urologic Oncology Group

  • Inamoto, Teruo;Azuma, Haruhito;Nonomura, Norio;Nakatani, Tatsuya;Matsuda, Tadashi;Nozawa, Masahiro;Ueda, Takeshi;Kinoshita, Hidefumi;Nishimura, Kazuo;Kanayama, Hiro-Omi;Miki, Tsuneharu;Tomita, Yoshihiko;Yoshioka, Toshiaki;Tsujihata, Masao;Uemura, Hirotsugu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1811-1815
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    • 2014
  • Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.

Annealing Cycle Dependence of MR Properties for Free Layer in $Ni_{25}Mn_{75}-Spin$ Valve Films ($Ni_{25}Mn_{75}-Spin$ Valve 박막 자유층의 열처리 순환수에 따른 자기저항 특성)

  • 이낭이;이주현;이가영;김미양;이장로;이상석;황도근
    • Journal of the Korean Magnetics Society
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    • v.10 no.2
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    • pp.62-66
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    • 2000
  • Annealing cycle number and nonmagnetic layer thickness dependences of interlayer coupling field ( $H_{inf}$ ) and coercivity ( $H_{cf}$ ) of free magnetic layer on NiMn alloy-spin valve films (SVF) were investigated. The SVF is Glass (7059)/N $i_{81}$F $e_{l9}$(70 $\AA$)/Co(10 $\AA$)/Cu(t $\AA$)/Co(15 $\AA$)N $i_{81}$$Fe_{19}$(35 $\AA$)/N $i_{25}$M $n_{75}$(250 $\AA$)Ta(50 $\AA$) films, it were fabricated using the dc sputtering method at different pinning layer thickness and nonmagnetic spacer thickness (Cu thickness; 30 $\AA$, 35 $\AA$, 40 $\AA$) of NiMn alloy with 25 at.%. Ni In case that Cu thickness of SVF is 35 $\AA$ and peak exchange coupling field ( $H_{ex}$) was 620 Oe, while coercivity $H_{c}$ = 280 Oe and MR ratio showed 2.5%. As for $H_{inf}$ and $H_{cf}$ , every SVF increased up to the stabilized values with the increase of annealing cycle number 15, which were $H_{inf}$ of 120 Oe and $H_{cf}$ of 75 Oe. The increase of $H_{cf}$ with the annealing cycle number seems to be caused by the effective reduction of Cu layer thickness due to the increase of interfacial mixing of Cu layer and Co layer. In addition, the $H_{inf}$ and $H_{cf}$ dependences of free NiFe layer by the interfacial mixing effect were appeared the different aspects when Cu layer becomes more thinner and thicker than Cu layer thickness of 35 $\AA$, respectively.ively....

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Snuffbox Arteriovenous Fistula Formation for Hemodialysis (Snuffbox에 시행한 혈액투석을 위한 동정맥루조성술)

  • 서필원;류재욱;박정옥;장성욱;김미순;박성식;김삼현
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.154-159
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    • 2004
  • The arteriovenous fistula (AVF), which maintains satisfactory blood flow, is necessary to the patients of end-stage renal disease for the long term hemodialysis. We performed the snuffbox fistula as the first operation for hemodialysis vascular access. This study was performed to investigate the patency rates, complications, risk factors for occlusion of the AVF, and the types of reoperations. Material and Method: We performed 146 snuffbox fistulas from Jun. 1994 to Dec. 2001 The records of the patients except six patients who were lost from follow up were analyzed retrospectively, Mean age and male:female ratio were 52$\pm$15 years (range, 17∼79 years) and 80 : 60 respectively. Diabetes mellitus and hypertension were combined in 47 patients and 101 respectively. Preoperative levels of creatinine and potassium were 9.09$\pm$3.68 mg/dL (range, 2.55∼20.09 mg/dL) and 4.7$\pm$0.9 mmol/L (range, 2.3∼8.1 mmol/L). One hundred thirteen cases of the snuffbox fistulas were done at left side hand and the others at right hand. Result: Mean follow up period of the patients was 41.8$\pm$31.0 months (range, 0.2∼108,8 months). During the follow up period, 35 occlusions of AVF occurred and these AVFs were patent for 9.8$\pm$10.1 months (range, 0.1∼40.4 months). The patency rates of f month, and 1, 2, 3, 5 years were known as 92.8, 80.2, 73.8, 71.3, 69.6% respectively. Right sided snuffbox fistulas (p-value=0.045) and old age (p-value=0.048) were revealed as significant risk factors for occlusion of AVF. The postoperative complications consisted of occlusions of AVF caused by intimal hyperplasia of vein in 24, thrombosis in nine, stenosis of anastomosis site in three, and venous hypertensions in two. After the first operation 37 patients underwent 86 reoperations. Conclusion: The snuffbox fistulas showed acceptable patency rates and low complication rates. The snuffbox fistulas as the first operation for AVF formation can be a good option for the patients with end-stage renal disease.

Effects of Copper and Zinc Supplementation on Growth Performance, Nutrient Digestibility, Meat and Carcass Characteristics in Finishing Pigs (구리 및 아연의 수준별 급여가 비육돈의 생산성, 영양소 소화율, 육질 및 도체 특성에 미치는 영향)

  • Kim, Y.H.;Kim, H.J.;Park, J.C.;Jung, H.J.;Cho, J.H.;Chen, Y.J.;Yoo, J.S.;Kim, I.C.;Lee, S.J.;Kim, I.H.
    • Food Science of Animal Resources
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    • v.27 no.3
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    • pp.284-289
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    • 2007
  • This study was conducted to investigate the effects of copper and zinc supplementation on growth performance, nutrient digestibility, and meat and carcass characteristics in finishing pigs. A total of 72 $(Landrace{\times}Yorkshire{\times}Duroc)$ pigs (58.47 kg initial BW) were assigned to 6 treatments in a $2{\times}3$ factorial design $(Zn\;levels{\times}Cu\;levels)$. The sources of zinc and copper were Zn-methionine chelate and Cu-methionine chelate, respectively. Zinc levels used were 80 and 120 ppm and copper levels used were 10, 30 and 60 ppm. Throughout the entire experimental period, the average daily gain (ADG) and average daily feed intake (ADFI) were not significantly affected by Cu or Zn levels, or their relative levels. The G:F ratio was significantly affected by the relative levels of Cu and Zn (p<0.05), specifically at 30 ppm Cu and 120 ppm Zn. Dry matter digestibility was significantly affected by the levels of Cu (p<0.02), Zn (p<0.01) and the relative levels of each (p<0.04), in particular at 30 ppm Cu and 120 ppm Zn. Nitrogen digestibility was significantly affected by Zn levels (p<0.01) and the combination of 30 ppm Cu and 120 ppm Zn (p<0.03). The $L^*-value$, shear force, cooking loss and pH were not significantly affected by Cu levels, Zn levels or their combination. The $a^*- (p<0.04)\;and\;b^*- values (p<0.01)$ were significantly affected by Zn levels at 80 ppm. The Water hoding capacity was significantly affected by Cu and Zn in combination (p<0.01) at 10 ppm Cu and 120ppm Zn. The carcass weight, backfat thickness and carcass grade were not significantly affected by Cu levels, Zn levels or their relative levels. The carcass percentage was significantly affected by the combination (p<0.04) of 30ppm Cu and 120ppm Zn. In conclusion, dietary supplementation of Cu and Zn at 30 and 120 ppm, respectively, is effective for feed efficiency, nutrient digestibility and carcass percentage, while at the levels of Cu at 10 ppm and Zn at 120 ppm have effects on WHC.

Clinical Usefulness of the Line Probe Assay for Rapid Detection of Rifampicin-resistant Tuberculosis (Line probe assay를 이용한 신속한 rifampicin내성결핵 진단법의 임상적 유용성)

  • Hong, Sang-Bum;Lim, Chae-Man;Lee, Sang-Do;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.3
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    • pp.334-342
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    • 2001
  • Background : RpoB gene mutations have been found in about 96-98% of rifampicin (RMP)-resistant Mycobacterium tuberculosis. Recent reports confirm that the in laboratory settings a rpoB gene mutation can be used as a surrogate marker for multi-drug resistant tuberculosis. However, its usefulness in clinical applications has not been evaluated. This study was performed to confirm whether mutation analysis of the rpoB gene of M. tuberculosis is useful in clinical settings. Methods : The medical records of 33 patients in whom rpoB gene analysis was conducted using an INNOLiPA Rif. TB assay (LiPA) from June, 1998, to July, 2000, at the Asan Medical Center were retrospectively reviewed in 33 patients. The clinical characteristics in addition to the drug susceptibility and LiPA results were analyzed. The drug susceptibility test was considered as a gold standard method for M. tuberculosis susceptibility and these results were compared with those of the rpoB gene study and sequencing analysis. Sequencing analysis of the rpoB gene was done in cases where there was a discrepancy between the results of the drug susceptibility an d rpoB gene study. Results : The mean age and sex ratio was $42{\pm}18$, and 24:9 (M:F), respectively. There were 19 RMP susceptible (58%) and 14 RMP-resistant cases (42%) according to the rpoB gene study. The mean time from the request to reporting the results of the rpoB gene study was $5.2{\pm}2.6$ days. The mean gap from reporting the rpoB gene study to reporting the susceptibility was $56{\pm}35$ days. Twenty-eight cases (85%) showed identical results compared with the drug susceptibility results, whereas five cases (15%) showed contradictory results. When compared with the sequencing analysis, of the five cases that showed contradictory results, two had LiP A analysis errors and the remaining three were identical to the sequencing results. The rpoB gene study was of assistance in choosing the appropriate drugs in 28 cases (85%). Conclusions : An rpoB gene study using an LiP A assay was useful in rapidly diagnosing RMP-resistant tuberculosis, which enabled a proper choice of the appropriate drugs in clinical practices. However, an LiPA assay always should be performed in conjunction with microscopy, culture, and susceptibility tests.

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