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Properties of Blood Pressure and Routine Laboratory Test Results by the Status of Smoking and Alcohol Intakes in Male Workers (일부 산업장 남성근로자들의 흡연,음주실태에 따른 혈압 및 혈액검사치의 특성)

  • Yoo, Chang-Kyun;Jeong, Yong-Jun
    • Korean Journal of Health Education and Promotion
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    • v.20 no.1
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    • pp.131-145
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    • 2003
  • This study was conducted to estimate the incidence and the degree of cigarette smoking and drinking among working men, and then to investigate the effects on blood pressure, various hematological indices and blood chemistry. The sample consisted of 2,287 male workers who had undertaken a general health check-up during the two-year period from January, 2000 to December, 2001. Such factors as blood pressure, blood glucose, lipid profiles, and liver function tests were determined and then analyzed with respect to the subjects smoking and/or drinking status. The major findings from this study are: 1. The drinking and smoking status have shown that 52.7% of participants were in the habit of both drinking and smoking while 11.6% were not associated with either. On the other hand 25.4% were involved only in drinking and 10.2% only in smoking. In the group smoking over 21 cigarettes per day over 30, the age group occupied the largest proportion at 20.1%. 2. Regarding the relationship between smoking and/or drinking status, and blood pressure, hematology and blood chemistry, the smoking and/or drinking group had significantly higher levels of blood pressure, both systolic and diastolic, Hb & Hct, TG, LDL-C, SGOT, and ${\gamma}$-GTP, than the non-smoking and/or non-drinking group. But HDL-C was significantly lower in the smoking group and significantly higher in the drinking group than the non-smoking/non-drinking group. 3. Regarding amount smoked, a larger number of cigarettes per day was significantly associated with the higher levels of blood pressure, systolic and diatolic, TG, TC, LDL-C, Hb, Hct, and ${\gamma}$-GTP. As for the amount druck, an increasing amount of alcohol intake was associated with rising levels of blood pressure, systolic and diatolic, TG, TC, LDL-C, HDL-C, Hb, SGOT, and ${\gamma}$-GTP. 4. Regarding the correlation among all the variables stated above, the smoking and drinking amount was shown to be in the positive correlation with blood pressure, both systolic and diastolic, TG, TC, Hb, and ${\gamma}$-GTP. On the contrary, LDL-C and HDL-C was in a positive correlation only with the amount drunk amount, and Hct only with the amount smoked. 5. As with systolic and diastolic blood pressure, the odds ratio of the smoking group was 2.35 and 2.58 compared to the non-smoking/drinking group. whereas it was 1.47 and 1.75 in the smoking/drinking group. Concerning serum lipids, the smoking/drinking group had 1.97 times the levels of TG in the non-smoking/non-drinking group, though the smoking group had 1.55 times the levels of HDL-C in the non-smoking/non-drinking group. As with liver function test results, the drinking group had 2.50 times and the smoking/drinking group had 4.41 times the levels of ${\gamma}$-GTP in the non-smoking/drinking group. respectively. The above results revealed that smoking and alcohol intake were effected the results of blood pressure and laboratory tests. Specifically, not only the smoking/drinking group but also those only smoking or only drinking were not as desirable as the non-smoking and non-drinking group to the results of blood pressure and laboratory tests.

Diffusion-Weighted MR Imaging of Various Intracranial Diseases : Clinical Utility (다양한 두개강내 질환의 확산강조 자기공명영상 : 임상적 유용성)

  • 김영준
    • Investigative Magnetic Resonance Imaging
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    • v.2 no.1
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    • pp.104-112
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    • 1998
  • Purpose : To evaluate the clinical utility of diffusion-weighted imaging by analyzing the signal intersity of lesions in patients with various intracranial diseases. Materials and Methods : difusion-weighted MR imaging was prospectively perormed in randomly selected 70 patients with various intracranial idseases. They consisted of 20 patients with acute infarct, 21 patients with chronic infarct of small vessel disease, 14 patients with primary intracranial tumor, three patients with brain metastasis, five patient with brain abscess, five patients with brain abscess, five patients with cerebral hemorrhage, one patient with neurocysticercosis, and one patient with epidermoid cyst. the diffusion-weighted images were obtained immediately after routine T2-weighted imaging on a 1.5T MR unit using single shot spin echo EPI technique with 6500 ms TR, 107ms TE, $128{\times}128$ matrix, 1 number of excitation, $24{\times}24$ field of view, 5-7 mm slice thickness, 2-3 mm inter-slice gap. The diffusion-gradients (b value of ($1000s{\;}/{\;}textrm{mm}^2$)) were applied along three directions(x, y, z). On visual inspection of diffusion-weighted images, the signal intersity of lesions was arbitrarily graded as one of 5 grades. In quantitative assessment, we measured the signal intensity of all the lesions and the contralateral corresponding normal area using round region of interest(ROI), and then calculated the signal intensity ratio of the lesion to the normal brain parenchyma. Results : On visual inspection, markedly hyperintense signals were seen in all cases of acute infarct, brain abscess, epidermoid cyst, and neurocysticercosis in degenerating stage. In all cases of cerebral hematoma, the very high signal internsity was intermingled with low signal intensity. focal very high signal intersity was also seen in a solid portion of the tumor in a patient. the mean signal intensity ratios of all those lesions to the normal brain parenchyma were above 2.5. Gliosis, solid component of brain tumor, brain metastasis, and vasogenic dedma appeared isointense to the normal brain parenchyma in 71%, 64%, 100%, and 67%, respectively ; the mean signal intensity ratios of those lesions to the normal brain parenchyma ranged 1.15 to 1.28 and there was no significant difference among these(p>0.1). Cystic cerebromalacia and necrotic or cystic portions in tumor were markedly or slightly hypointense, and the mean signal intensity ratios were 0.45 and 0.42, respectively. Conclusion : Very high signal intensity of acute infarct, brain abscess, epidermoid cyst, and cystic neurocysticercosis in degenerating stage on diffusion-weighted images may be helpful in differentiating from other diseases that are hypointense or isointense to the normal brain parenchyma. It may be especially useful differentiation of brain abscess from brain tumor with necrotic or cystic portion.

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Objective in Vivo Quantification of Emphysema by Thin-Section CT: Correlation with Physiologic Findings (고해상 전산화단층촬영을 이용한 폐기종의 정량적 분석: 폐기능 검사와의 비교)

  • Lee, Jee-Young;Lee, Kye-Young;Choi, Eun-Kyoung;Kim, Sang-Joon;Choi, Young-Hi
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.992-999
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    • 1998
  • Background: To correlate the emphysema score for quantification of the overall extent of emphysema in both lungs by CT with physiologic fingings and to get more objective and simple method to assess the extent of emphysema. Method: Thin-section CT and pulmonary function test(PFT) were performed in 17 patients with emphysema (all males, mean age, 62 years). Emphysema score was obtained as percentage of emphysematous lung area, dividing the total area of the emphysema(voxels with attenuation value less than -880, -900, -920HU, respectively) by the overall area of both lungs(voxels with attenuation value less than -400HU) with highlighting voxels using "Density mask" program. Emphysema score was calculated from whole lung(ESV) and 5 representative scans(ESR) using "Density mask", Visual emphysema score(ESV) was obtained by visual assessment from 5 representative scans. Correlation of these emphysema scores(ESW, ESR, ESV) and physiologic findings were performed, comparing the ESW with ESR and ESV. Results: ESW had correlation with DLCO(r=0.53-0.64) and $FEV_1/FVC$(r=0.42-0.57) among PFT parameters. ESR had good correlation with ESW and with PFT parameters as well. ESV did not correlate with PFT parameters except DLCO. Conclusion: CT quantification of emphysema using "density mask" correlated well with physiologic findings. To assess the severity of emphysema, both ESW and ESR are more reliable than ESV, and ESR is recommended in routine practice as it is objective, simple and reliable.

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Usability of Urinary Reagent Strips in Diagnosis of Meningitis (뇌수막염의 진단에서 뇨검사 시험지를 이용한 뇌척수액 검사의 유용성)

  • Jeong, Jin Yeong;Park, Sang Kyu
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.265-270
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    • 1997
  • Purpose: Rapid diagnosis and prompt treatment remain the cornerstone of management of patients with meningitis. Examination of cerebrospinal fluid(CSF) for glucose, protein, cells, and organisms is necessary for accurate diagnosis, but in many parts of the world facilities do not exist to do so. We tested CSF samples from 69 children with suspected meningitis with urinary reagent strips and analyzed the results to know the usability of urinary reagent strips in diagnosis of meningitis. Methods: 69 CSF samples obtained from children with suspected meningitis were analysed. Each sample was divided into two; one was sent to the laboratory for routine diagnostic evaluation, and the other was tested with the reagent strip(Combur10 Test M). Laboratory values of CSF glucose, protein, and leucocytes for each CSF sample were plotted against the corresponding reagent-strip category. Results: There was good agreement between the dipstick and laboratory values for CSF protein and cell count but not for glucose. Conclusion: Rapid diagnosis of meningitis could be made with three component of the Combur10 test strip. It is easy to do and would be of particular value to those working in parts of the world where no laboratory facilities exist.

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Mathematical Transformation Influencing Accuracy of Near Infrared Spectroscopy (NIRS) Calibrations for the Prediction of Chemical Composition and Fermentation Parameters in Corn Silage (수 처리 방법이 근적외선분광법을 이용한 옥수수 사일리지의 화학적 조성분 및 발효품질의 예측 정확성에 미치는 영향)

  • Park, Hyung-Soo;Kim, Ji-Hye;Choi, Ki-Choon;Kim, Hyeon-Seop
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.36 no.1
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    • pp.50-57
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    • 2016
  • This study was conducted to determine the effect of mathematical transformation on near infrared spectroscopy (NIRS) calibrations for the prediction of chemical composition and fermentation parameters in corn silage. Corn silage samples (n=407) were collected from cattle farms and feed companies in Korea between 2014 and 2015. Samples of silage were scanned at 1 nm intervals over the wavelength range of 680~2,500 nm. The optical data were recorded as log 1/Reflectance (log 1/R) and scanned in intact fresh condition. The spectral data were regressed against a range of chemical parameters using partial least squares (PLS) multivariate analysis in conjunction with several spectral math treatments to reduce the effect of extraneous noise. The optimum calibrations were selected based on the highest coefficients of determination in cross validation ($R^2{_{cv}}$) and the lowest standard error of cross validation (SECV). Results of this study revealed that the NIRS method could be used to predict chemical constituents accurately (correlation coefficient of cross validation, $R^2{_{cv}}$, ranging from 0.77 to 0.91). The best mathematical treatment for moisture and crude protein (CP) was first-order derivatives (1, 16, 16, and 1, 4, 4), whereas the best mathematical treatment for neutral detergent fiber (NDF) and acid detergent fiber (ADF) was 2, 16, 16. The calibration models for fermentation parameters had lower predictive accuracy than chemical constituents. However, pH and lactic acids were predicted with considerable accuracy ($R^2{_{cv}}$ 0.74 to 0.77). The best mathematical treatment for them was 1, 8, 8 and 2, 16, 16, respectively. Results of this experiment demonstrate that it is possible to use NIRS method to predict the chemical composition and fermentation quality of fresh corn silages as a routine analysis method for feeding value evaluation to give advice to farmers.

A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours (병원 간호사의 선호근무시간대에 관한 연구)

  • Lee, Gyeong-Sik;Jeong, Geum-Hui
    • The Korean Nurse
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    • v.36 no.1
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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Study on the Effect of Deep Fertilization on Paddy Field - Efficiency of Ball Complex Fertilizer Mixed with Zeolite - (수도(水稻)에 대(對)한 심층추비효과(深層追肥効果)에 관(關)한 연구(硏究) - Zeolite 첨가(添加) Ball complex 비료(肥料)의 비효(肥効) -)

  • Kim, Tai-Soon;U., Zang-Kual
    • Korean Journal of Soil Science and Fertilizer
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    • v.10 no.1
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    • pp.61-67
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    • 1977
  • A study was conducted in order to compare the topdressing method of the conventional fertilizers as control and the deep application method of the ball complex fertilizer newly developed. The ball complex fertilizer consisted of 5% of nitrogen, 5% of phosphorus, and 7% of potassium. Basal application of nitrogen for the rice plant was the same for both control plots and ball complex plots. One ball complex fertilizer per four hills was applied at depth of 12~13cm 35days before heading stage while control plot received three times topdressing at different growth stages as usual practice. The results obtained were as follows. 1. The ball complex fertilizer applied in the soil was continuously utilized by the rice plants until harvest time while nitrogen and potassium uptake of control plots was reduced rapidly after heading stage. Daily uptake of nitrogen and potassium per hill at maturing stage were 0.45mg and 0.68mg in control plots, but 4.80mg and 7.0mg respectively in ball complex plots. 2. Dry matter productivity of the rice plant in control plots, well coinciding with nutrients uptake pattern, was maximum just after heading stage decreased at maturing stage. But dry matter productivity in ball complex plots was much higher at maturing stage than at heading stage. 3. Ball complex application increased effective tillering rate, causing higher panicle number per hill. 4. Ball complex application brought about 528kg/10a of hulled grain yield while the conventional practice 423kg/10a. 5. Deep application of ball complex was superior to usual practice in terms of yield components such as panicle number per hill, filled grain number per panicle, maturing rate, and 1,000 grain weight. 6. From the morphological characteristics point of view, the deep application of ball complex made the flag leaf and the 2nd leaf heavier, larger and broader as compared to control treatment. 7. It is considered that by applying the ball complex fertilizer at depth of 12~13cm sufficient amount of nitrogen and potassium could be utilized by rice plants during the maturing stage and assimilated in the leaf blade, consequently making the flag leaf and the 2nd leaf bigger and healthier. The fact can easily explain that the ball complex plots had higher capacity of photosynthesis, less discoloration of lower leaves, bigger leaf area index, and better grain yield as compared to the conventional practice. In conclusion the deep application method of the ball complex fertilizer was superior to the routine topdressing method of the usual fertilizers.

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Function of the Neuronal $M_2$ Muscarinic Receptor in Asthmatic Patients (천식 환자에서 $M_2$ 무스카린성 수용체 기능에 관한 연구)

  • Kwon, Young-Hwan;Lee, Sang-Yeup;Bak, Sang-Myeon;Lee, Sin-Hyung;Shin, Chol;Cho, Jae-Youn;Shim, Jae-Jeong;Kang, Kyung-Ho;Yoo, Se-Hwa;In, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.486-494
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    • 2000
  • Background : The dominant innervation of airway smooth muscle is parasympathetic fibers which are carried in the vagus nerve. Activation of these cholinergic nerves releases acetylcholine which binds to $M_3$ muscarinic receptors on the smooth muscle causing bronchocontraction. Acetylcholine also feeds back onto neuronal $M_2$ muscarinic receptors located on the postganglionic cholinergic nerves. Stimulation of these receptors further inhibits acetylcholine release, so these $M_2$, muscarinic receptors act as autoreceptors. Loss of function of these $M_2$ receptors, as it occurs in animal models of hyperresponsiveness, leads to an increase in vagally mediated hyperresponsiveness. However, there are limited data pertaining to whether there are dysfunctions of these receptors in patients with asthma. The aim of this study is to determine whether there are dysfunction of $M_2$ muscarinic receptors in asthmatic patients and difference of function of these receptors according to severity of asthma. Method : We studied twenty-seven patients with asthma who were registered at Pulmonology Division of Korea University Hospital. They all met asthma criteria of ATS. Of these patients, eleven patients were categorized as having mild asthma, eight patients moderate asthma and eight patients severe asthma according to severity by NAEPP Expert Panel Report 2(1997). All subjects were free of recent upper respiratory tract infection within 2 weeks and showed positive methacholine challenge test ($PC_{20}$<16mg/ml). Methacholine provocation tests were performed twice on separate days allowing for an interval of one week. In the second test, pretreatment with the $M_2$ muscarinic receptor agonist pilocarpine($180{\mu}g$) through inhalation was performed be fore the routine procedures. Results : Eleven subjects with mild asthma and eight subjects with moderate asthma showed significant increase of $PC_{20}$ from 5.30$\pm$5.23mg/ml(mean$\pm$SD) to 20.82$\pm$22.56mg/ml(p=0.004) and from 2.79$\pm$1.51mg/ml to 4.67$\pm$3.53mg/ml(p=0.012) after pilocarpine inhalation, respectively. However, in the eight subjects with severe asthma significant increase of $PC_{20}$ from l.76$\pm$1.50mg/ml to 3.18$\pm$4.03mg/ml(p=0.161) after pilocarpine inhalation was not found. Conclusion : In subjects with mild and moderate asthma, function of $M_2$ muscarinic receptors was normal, but there was a dysfunction of these receptors in subjects with severe asthma. ηlese results suggest that function of $M_2$ muscarinic receptors is different according to severity of asthma.

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Prospective Study of the Immunologic Factors Affecting the Prognosis of Severe Community-Acquired Pneumonia (중증 지역사회획득 폐렴환자의 예후에 영향을 미치는 면역지표에 대한 연구)

  • Hwang, Jae-Kyung;Lee, Ho-Moeng;Song, Kwang-Sik;Park, Gye-Young;Park, Jeong-Woong;Park, Jae-Kyung;Jeong, Seong-Hwan;Ahn, Jeong-Yeal;Seo, Yiel-Hea;Nam, Gui-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.437-449
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    • 2001
  • Background : In the severe community-acquired pneumonia, it has been known that the immune status is occasionally suppressed. This study was performed to identify the immunologic markers related with the prognostic factors in severe community-acquired pneumonia. Methods : 23 patients with severe community-acquired pneumonia were involved in this study, and divided into survivor (16) and nonsurvivor (7) groups. In this study, the medical history, laboratory tests(complete blood counts, routine chemistry profile, immunoglobulins, complements, lymphocyte subsets, cytokines, sputum and blood culture, urine analysis), and chest radiographs were scrutinized. Results : 1) Both groups had lymphopenia(total lymphocyte count $995.6{\pm}505.7/mm^3$ in the survivor and $624.0{\pm}287.6/mm^3$ in the nonsurvivor group). 2) The T-lymphocyte count of the nonsurvivor group($295.9{\pm}203.0/mm^3$) was lower than the survivor group($723.6{\pm}406.5/mm^3$) (p<0.05). 3) The total serum protein(albumin) was $6.0{\pm}1.0(2.7{\pm}0.7)\;g/d{\ell}$ in the survivor and $5.2{\pm}1.5(2.3{\pm}0.8)g/d{\ell}$ in the nonsurvivor group. The BUN of the nonsurvivor group($41.7{\pm}30.0mg/d{\ell}$) was higher than that of the survivor group($18.9{\pm}9.8mg/d{\ell}$)(p<0.05). The creatinine concentration was higher in the nonsurvivor group($1.8{\pm}1.0mg/d{\ell}$) than that in the survivor group($1.0{\pm}0.3mg/d{\ell}$)(p<0.05). 4) The immunoglobulin G level was higher in the survivor group($1433.0{\pm}729.5mg/d{\ell}$) than in the nonsurvivor group($849.1{\pm}373.1mg/d{\ell}$) (p<0.05). 5) The complement $C_3$ level was $108.0{\pm}37.9mg/d{\ell}$ in the survivor group and $88.0{\pm}32.1mg/d{\ell}$ in the nonsurvivor group. 6) A cytokine study showed an insignificant difference in both groups. 7) Chronic liver disease, DM, and COPD were major underlying diseases in both groups. Conclusion : These results suggest that decreased a T-lymphocyte count and immunoglobulin G level, and an increased BUN and creatinine level may be associated with the poor prognosis of severe community-acquired pneumonia.

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Comparative Analysis of Delivery Management in Various Medical Facilities (의료기관별 분만관리 양상의 비교 분석)

  • Park, Jung-Han;You, Young-Sook;Kim, Jang-Rak
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.4 s.28
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    • pp.555-577
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    • 1989
  • This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183 (23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding/clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents. sedatives. digestives. stool softeners. antihistamines. and diuretics. Mean hospital day for the normal vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.

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