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Impact of postoperative dietary types on nutrition and treatment prognosis in hospitalized patients undergoing oral and maxillofacial surgery: a comparative study

  • Sung Bin Youn;Se-Hui Ahn;Dong-Ho Cho;Hoon Myoung
    • Korean Journal of Community Nutrition
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    • v.29 no.2
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    • pp.129-143
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    • 2024
  • Objectives: The objective of this study is to compare a nutritionally balanced soft blend diet (SBD) with a soft fluid diet (SFD) on the health of inpatients who have undergone oral and maxillofacial (OMF) surgery, ultimately aiming to enhance care outcomes, improve health-related quality of life (QOL), and increase satisfaction with the hospital. Methods: Thirty-two patients were randomized into two groups: sixteen received SFD and sixteen received SBD. Anthropometric, laboratory evaluations were conducted upon admission and discharge. Patients filled out questionnaires on demographics, diet satisfaction, food intake amount, and health-related QOL on the day of discharge, assessed using the EuroQoL 5 Dimensions 3 Level and EuroQoL Visual Analogue Scale (EQ-VAS) instruments. Data were analyzed with descriptive statistics, χ2 tests for group differences, and paired nonparametric t-tests for within-group comparisons. The Mann-Whitney U test evaluated inter-group differences in preoperative weight and body mass index (BMI), postoperative changes, meal satisfaction, intake, health-related QOL, and self-assessed health status. P-values were set at a significance level of 0.05. Results: The SBD group had higher dietary intake (63.2% vs. 51.0%) and greater diet satisfaction (80.6 vs. 48.1, P < 0.0001) compared to SFD group. Health-related QOL, measured by EQ-VAS, was better in SBD group (70.3 vs. 58.8, P < 0.05). Postoperative weight and BMI decreased in SFD group but increased in SBD group (P < 0.01). Changes in laboratory results showed more stability in the SBD group. No postoperative infections were reported in SBD group, whereas SFD group had a 31.25% complication rate. Conclusions: While SFD is often recommended after OMF surgery to protect oral wound healing process, our study reveals that SBD not only enhances physical and psychological outcomes but also, somewhat unexpectedly, supports wound healing and reduces complications. Essentially, SBD promotes physical recovery and enhances health-related QOL than SFD by supporting both somatic and mental healing aspects.

Pancreaticoduodenectomy with superior mesenteric artery first-approach combined total meso-pancreas excision for periampullary malignancies: A high-volume single-center experience with short-term outcomes

  • Thanh Khiem Nguyen;Ham Hoi Nguyen;Tuan Hiep Luong;Kim Khue Dang;Van Duy Le;Duc Dung Tran;Van Minh Do;Hong Quang Pham;Hoan My Pham;Thi Lan Tran;Cuong Thinh Nguyen;Hong Son Trinh;Yosuke Inoue
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.1
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    • pp.59-69
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    • 2024
  • Backgrounds/Aims: Pancreaticoduodenectomy (PD) is the only radical treatment for periampullary malignancies. Superior mesenteric artery (SMA) first approach combined with total meso-pancreas (MP) excision was conducted to improve the oncological results. There has not been any previous research of a technique that combines the SMA first approach and total MP excision with a detailed description of the MP macroscopical shape. Methods: We prospectively assessed 77 patients with periampullary malignancies between October 2020 and March 2022 (18 months). All patients had undergone PD with SMA first approach combined total MP excision. The perioperative indications, clinical data, intra-operative index, R0 resection rate of postoperative pathological specimens (especially mesopancreatic margin), postoperative complications, and follow-up results were evaluated. Results: The median operative time was 289.6 min (178-540 min), the median intraoperative blood loss was 209 mL (30-1,600 mL). Microscopically, there were 19 (24.7%) cases with metastatic MP, and five cases (6.5%) with R1-resection of the MP. The number of lymph nodes (LNs) harvested and metastatic LNs were 27.2 (maximum was 74) and 1.8 (maximum was 16), respectively. Some (46.8%) patients had pancreatic fistula, but mostly in grade A, with 7 patients (9.1%) who required re-operations. Some 18.2% of cases developed postoperative refractory diarrhea. The rate of in-hospital mortality was 1.3%. Conclusions: The PD with SMA first approach combined TMpE for periampullary malignancies was effective in achieving superior oncological statistics (rate of MP R0-resection and number of total resected LNs) with non-inferior short-term outcomes. It is necessary to evaluate survival outcomes with long-term follow-up.

Tectonic Movement in the Korean Peninsula (II): A Geomorphological Interpretation of the Spatial Distribution of Earthquakes (한반도의 지반운동 (II): 한반도 지진분포의 지형학적 해석)

  • Park, Soo-Jin
    • Journal of the Korean Geographical Society
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    • v.42 no.4
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    • pp.488-505
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    • 2007
  • The purposes of this research are twofold; 1) to verify spatial differences of tectonic movement using the spatial distribution of earthquakes, and 2) to infer mechanisms that generate spatial accumulation patterns of earthquakes in the Korean Peninsula. The first part of this sequential paper (Park, 2007) argues that the Korean Peninsula consists of four geostructural regions in which tectonic deformation and consequent geomorphological development patterns are different from each other Since this conclusion has been made by terrain analyses alone, it is necessary to verify this suggestion using other independent geophysical data. Because earthquakes are results of movement and deformation of land masses moving in different directions, the distribution of earthquake epicenters may be used to identify the direction and rates of land mass movement. This paper first analysed the spatial distribution of earthquakes using spatial statistics, and then results were compared with the spatial arrangement of geostructural regions. The spatial distribution of earthquakes in the Korean Peninsula can be summarized as the followings; firstly, the intensity of earthquakes shows only weak spatial dependency, and shows large difference even at adjacent regions. Secondly, the epicenter distribution has a clear spatial accumulation pattern, even though the intensity of earthquake shows a random pattern. Thirdly, the high density area of earthquakes shows a clear 'L' shape, passing through Pyeongannam-do, centered at Pyeongyang, and Hwanghae-do, Seosan and Pohang. The correlation coefficient between the density of earthquakes and distance from geostructral region boundaries is much higher than those between the density of fault lines and distance from tectonic division boundaries. Since fault lines and tectonic divisions in the Korean Peninsula are the results of long-term geological development, there is an apparent scale discrepancy to find significant correlations with earthquakes. This result verifies the research hypothesis that the Korean Peninsula is divided into four geostructral regions in which each has its own moving direction and spatial deformation characteristics. The existence of geostructural regions is also supported by the movement parrerns of land masses estimated from the GPS measurements. This conclusion is expected to provide a new perspective to understand the geomorphological developments and the earthquake occurrences in the Korean Peninsula.

Prediction of Seasonal Nitrate Concentration in Springs on the Southern Slope of Jeju Island using Multiple Linear Regression of Geographic Spatial Data (지리 공간 자료의 다중회귀분석을 이용한 제주도 남측사면 용천수의 시기별 질산성 질소 농도 예측)

  • Jung, Youn-Young;Koh, Dong-Chan;Kang, Bong-Rae;Ko, Kyung-Suk;Yu, Yong-Jae
    • Economic and Environmental Geology
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    • v.44 no.2
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    • pp.135-152
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    • 2011
  • Nitrate concentrations in springs at the southern slope of Jeju Island were predicted using multiple linear regression (MLR) of spatial variables including hydrogeological parameters and land use characteristics. Springs showed wide range of nitrate concentrations from <0.02 to 86 mg/L with a mean of 20 mg/L. Spatial variables were generated for the circular buffer when the optimal buffer radius was assigned as 400 m. Selected regression models were tested using the p values and Durbin-Watson statistics. Explanatory variables were selected using the adjusted $R^2$, Cp (total squared error) and AIC (Akaike's Information Criterion), and significance. In addition, mutual linear relations between variables were also considered. Small portion of springs, usually <10% of total samples, were identified as outliers indicating limitations of MLR using circular buffers. Adjusted $R^2$ of the proposed models was improved from 0.75 to 0.87 when outliers were eliminated. In particular, the areal proportion of natural area had the greatest influence on the nitrate concentrations in springs. Among anthropogenic land uses, the influence of nitrate contamination is diminishing in the following order of orchard, residential area, and dry farmland. It is apparent quality of springs in the study area is likely to be controlled by land uses instead of hydrogeological parameters. Most of all, it is worth highlighting that the contamination susceptibility of springs is highly sensitive to nearby land uses, in particular, orchard.

A Study on the Stability and Sludge Energy Efficiency Evaluation of Torrefied Wood Flour Natural Material Based Coagulant (반탄화목분 천연재료 혼합응집제의 안정성 및 슬러지 에너지화 가능성 평가에 관한 연구)

  • PARK, Hae Keum;KANG, Seog Goo
    • Journal of the Korean Wood Science and Technology
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    • v.48 no.3
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    • pp.271-282
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    • 2020
  • Sewage treatment plants are social infrastructure of cities. The sewage distribution rate in Korea is reaching 94% based on the sewage statistics based in the year of 2017. In Korean sewage treatment plants, use of PAC (Poly Aluminum Chloride) accounts for 58%. It contains a large amount of impurities (heavy metal) according to the quality standards, however, there have been insufficient efforts to reinforce the standards or technically improve the quality, which resulted in secondary pollution problems from injecting excessive coagulant. Also, the increase in the use of chemicals is leading to the increases in the annual amount of sewage sludge generated in 2017 and the need to reuse sludge. As such, this study aims to verify the possibility of reusing sludge by evaluating the stability of heavy metals based on the injection of coagulant mixture during water treatment which uses the torrefield wood powder and natural materials, and evaluating the sedimentation and heating value of sewage sludge. As a result of analyzing heavy metals (Cr, Fe, Zn, Cu, Cd, As, Pb, and Ni) from the coagulant mixture and PAC (10%), Cr, Cd, Pb, Ni, and Hg were not detected. As for Zn, while its concentration notified in the quality standards for drinking water is 3 mg/L, only a small amount of 0.007 mg/L was detected in the coagulant mixture. Maximum amounts of over double amounts of Fe, Cu, and As were found with PAC (10%) compared to the coagulant mixture. Also, an analysis of sludge sedimentation found that the coagulant mixture showed a better performance of up to double the speed of the conventional coagulant, PAC (10%). The dry-basis lower heating value of sewage sludge produced by injecting the coagulant mixture was 3,378 kcal/kg, while that of sewage sludge generated due to PAC (10%) was 3,171 kcal/kg; although both coagulants met the requirements to be used as auxiliary fuel at thermal power plants, the coagulant mixture developed in this study could secure heating values 200 kal/kg higher than the counterpart. Therefore, utilization of the coagulant mixture for water treatment rather than PAC (10%) is expected to be more environmentally stable and effective, as it helps generating sludge with better stability against heavy metals, having a faster sludge sedimentation, and higher heating value.

Serum Albumin Concentrations and Clinical Disorders by Gestational Ages in Preterm Babies (미숙아에서 재태 연령에 따른 혈청 알부민치와 임상증상과의 관계)

  • Lee, Mia;Yun, Soo;Lim, Baek Keun;Kim, Jong Soo
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.148-153
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    • 2005
  • Purpose : The aim of this study was to determine the reference ranges of serum albumin levels depending on the gestational ages of preterm infants. We also intended to compare the mean serum albumin levels between groups of preterm infants that did not develop clinical disorders later, and groups that did develop clinical disorders such as respiratory distress syndrome, intraventricular hemorrhage, retinopathy of prematurity, apnea and bronchopulmonary dysplasia. We also examined the significance of serum albumin as a predictor for the development of clinical disorders. Methods : The records of 208 neonates with gestational ages from 23 weeks to 41 weeks were reviewed retrospectively. The mean albumin concentrations with reference ranges by gestational ages were determined. Statistics for each two of group were compared. Logistic regression analysis was used to model odd ratio, and 95 percent confidence interval as a mean of the association between predictors and outcome. Results : Serum albumin levels were at 23-24 weeks gestation was 2.36 g/dL, rising to 3.43 g/dL in full term babies. There were significant mean differences between the clinical groups and control groups for each clinical disorder such as respiratory distress syndrome, intraventricular hemorrhage, retinopathy of prematurity and apnea in premature babies of 30-36 weeks of gestation. Low serum albumin appeared to be associated with increased risks of clinical disorders. Conclusion : The normal serum albumin levels in preterm infants should be defined according to the gestational ages. Lower albumin levels increase the risks of the later development of clinical disorders, which are common in premature infants.

Vitamin D Deficiency and Related Factors in Patients at a Hospice (일개 호스피스 병동에서 비타민 D 결핍 현황 및 관련인자)

  • Moon, Kyoung Hwan;Ahn, Hee Kyung;Ahn, Hong Yup;Choi, Sun Young;Hwang, In Cheol;Choi, Youn Seon;Yeom, Chang Hwan
    • Journal of Hospice and Palliative Care
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    • v.17 no.1
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    • pp.27-33
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    • 2014
  • Purpose: Although vitamin D deficiency is more commonly found in cancer patient than in non-cancer patients, there have been little data regarding the prevalence of vitamin D deficiency in cancer patients at the very end of life. We examined vitamin D deficiency in terminally ill cancer patients and related factors. Methods: This study was based on a retrospective chart review of 133 patients in a hospice ward. We collected data regarding age, sex, serum 25-hydroxyvitamin D level, cancer type, physical performance, current medications and various laboratory findings. We investigated factors related to serum vitamin D levels after multivariate adjustment for potential confounders. Serum 25-hydroxyvitamin D<20 ng/mL was considered deficient and <10 ng/mL severely deficient. Results: Ninety-five percent of the patients were serum vitamin D deficient. Severe vitamin D deficiency was more common in male patients, non-lung cancer patients, $H_2$ blocker users and non-anticonvulsant users. Elevated levels of serum alanine aminotransferase (ALT) were also associated with low serum vitamin D levels. Multiple regression analysis showed that severe vitamin D deficiency was associated with male gender (aOR 3.82, 95% CI: 1.50~9.72, P=0.005), $H_2$ blocker users (aOR 3.94, 95% CI: 1.61~9.65, P=0.003) and elevated serum ALT levels (aOR 4.52, 95% CI: 1.35~15.19, P=0.015). Conclusion: Vitamin D deficiency was highly prevalent among terminally ill cancer patients. Severe vitamin D deficiency was more common in male patients, $H_2$ blocker users, and patients with elevated ALT levels.

Distribution of Microorganisms in Perilla Leaf and Cultivation Area (들깻잎과 생산환경의 미생물 분포)

  • Kim, Se-Ri;Lee, Ji-Young;Lee, Seo-Hyun;Ko, Hyeon-Seok;Yoon, Yo-Han;Kwon, Se-Hyeok;Ryu, Kyoung-Yul;Yun, Hye-Jeong;Kim, Won-Il;Yun, Jong-Chul;Kim, Doo-Ho;Chung, Duck-Hwa
    • Korean Journal of Food Science and Technology
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    • v.43 no.2
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    • pp.243-248
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    • 2011
  • The prevalence and distribution of hazardous microorganisms were investigated from the major perilla cultivation area at Milyang, Gyeongnam province, Korea. Aerobic plate count (APC) and coliform count of perilla leaves were 4.82 log CFU/g and 3.85 log CFU/g, respectively. E. coli, S. aureus and B. cereus were detected in 3.0% (4/114), 7.9% (9/114) and 46.5% (53/114) of examined perilla leaves. However, E. coli O157:H7, Salmonella spp, and L. monocytogenes were not detected. The distribution of hazardous microorganisms in perilla leaf cultivation environment were compared and the concentration of APC and coliform counts were more than 3.0 log CFU/(mL, g, $100cm^2$, hand) from most of the samples. S. aureus were detected from irrigation water, packing table, packing vinyl, hand, and clothes. Also, B. cereus was frequently detected from the examined samples. Especially, packing table and collection container were contaminated with maximum 5.5 log $CFU/100cm^2$ of B. cereus. Good Agricultural Practice (GAP) system should be introduced to farms to enhance the safety of perilla leaves.

Analysis of Treatment Failure for the Pulmonary and Neck Tuberculosis (폐 및 경부 결핵에서 항결핵제에 의한 치료실패 원인분석)

  • Jeon, Chang-Ho;Lee, Sang-Chae;Hyun, Dae-Sung;Choe, Jung-Yoon;Shin, Im-Hee;Sohn, Jin-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.473-483
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    • 2001
  • Background : There are only a few studies regarding the causes of treatment failure for tuberculosis. Therefore, this study aimed to determine the causes of intractable tuberculosis. Methods : M. tuberculosis, differentiated MOTT (Mycobacterium Other Than Tuberculosis) were isolated, and the RFLP (Restriction fragments length polymorphisms) pattern was analyzed from 204 patients with pulmonary tuberculosis and 53 suffering from neck tuberculosis. The IL-$1{\beta}$, IL-12, $^*1\;IFN{\gamma}$ and $^*2\;TNF{\alpha}$ blood levels were measured. All patients were regularly followed for 18 months after treatment. Results : There was no correlation between the RFLP patterns of M. tuberculosis treatment failure. From the 204 cases, 31.9% were intractable. The characteristics of patients with intractable tuberculosis were old age, being male and recurrent cases. The causes of treatment failure were identified as follows ; a decrease in the IL-12(59.4%) concentration, drug resistant strain(54.7%), irregular medication(15.4%), MOTT(6.2%) and a heavy infection(4.6%). The causes of all cases of intractable tuberculosis could be investigated. The IL-12 concentration in the blood was significantly lower in the intractable cases, where it disclosed a maximum sensitivity(64.7%) and specificity(75.4%) at 165.0 pg/mL. Most of the 53 cases of neck node tuberculosis were treated successfully. Therefore, we were unable to analyze the cause of treatment failure. Conclusion : A decrease in the blood IL-12 concentration and drug resistant strains were identified as the most significant causes of treatment failure for tuberculosis. In Korea, infection by clusters were prevalent, but no difference in the clinical course between clusters and non-clusters could be found.

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The Change of Health Service before and after the Unification of two Health Subcenters in a Rural Area (한 농촌지역 2개면 보건지소 통합전후 보건의료사업 변화 연구)

  • Sul, Sue-Jeong;Park, Hyang;Sohn, Seok-Joon;Park, Jong;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.427-440
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    • 2000
  • A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

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