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Early stress hyperglycemia as independent predictor of increased mortality in preterm infants (미숙아에서 초기 스트레스성 고혈당과 예후 사이의 연관성)

  • Wee, Young Sun;Ahn, Gae Hyun;Yoo, Eun Gyong;Lim, In Sook;Lee, Kyu Hyung
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.474-480
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    • 2008
  • Purpose : Stress hyperglycemia is common in critically ill adult patients. It is known as a predictor of increased mortality, and intensive insulin therapy has been shown to improve the prognosis in such patients. We have investigated the relationship between early stress hyperglycemia and clinical outcomes in preterm infants. Methods : In this study, 141 preterm infants with a gestational age of less than 30 weeks were enrolled. The hyperglycemic group was defined as that having maximum glucose of more than 150 mg/dL (n=61) during the first 48 h of life, and the non-hyperglycemic group was defined as that having maximum glucose of less than 150 mg/dL (n=80). Perinatal history, severity of illness using the Clinical Risk Index for Babies (CRIB) score, clinical outcomes, and mortality of the two groups were compared. Results : There was no significant difference in the gestational age between the two groups, but the birth weight (P<0.001) was significantly lower, and the CRIB score (P<0.001) was significantly higher in the hyperglycemic group. Disseminated intravascular coagulation (P<0.001) and clinically suspected sepsis (P=0.046) were more common in the hyperglycemic group. Mortality was markedly higher in the hyperglycemic group (11.3% vs. 41.0%, P<0.001). On performing a stepwise multiple logistic regression analysis, hyperglycemia (OR 3.787; 95% CI 1.324 to 10.829), the CRIB score (OR 1.252; 95% CI 1.047 to 1.496) and birth weight (OR 0.997; 95% CI 0.994 to 1.000) was independently associated with higher mortality. Conclusion : Stress hyperglycemia within the first 48 h of life is independently related to increased morbidity and mortality in preterm infants.

Antithrombin-III as an early prognostic factor in children with acute lung injury (급성 폐손상 소아 환자에서 조기 예후 인자로서의 antithrombin-III)

  • Lee, Young Seung;Kim, Seonguk;Kang, Eun Kyeong;Park, June Dong
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.443-448
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    • 2007
  • Purpose : To evaluate the potential prognostic value of the antithrombin-III (AT-III) level in the children with acute lung injury (ALI), we analyzed several early predictive factors of death including AT-III level at the onset of ALI and compared the relative risk of them for mortality. Methods : Over a 18-month period, a total of 198 children were admitted to our pediatric intensive care unit and 21 mechanically ventilated patients met ALI criteria, as defined by American-European consensus conference, i.e., bilateral pulmonary infiltrates and $PaO_2/FiO_2$ lower than 300 without left atrial hypertension. Demographic variables, hemodynamic and respiratory parameters, underlying diseases, as well as Pediatric Risk of Mortality-III (PRISM-III) scores and Lung Injury Score (LIS) at admission were collected. AT-III levels were measured within 3 hours after admission. These variables were compared between survivors and non-survivors and entered into a multiple logistic regression analysis to evaluate their independent prognostic roles. Results : The overall mortality rate was 38.1% (8/21). Non-survivors showed lower age, lower lung compliance, higher PEEP, higher oxygenation index (OI), lower arterial pH, lower $PaO_2/FiO_2$, higher PRISM-III score and LIS, and lower AT-III level. PRISM-III score, LIS, OI and decreased AT-III level (less than 70%) were independently associated with a risk of death and the odds ratio of decreased AT-III level for mortality is 2.75 (95% confidence interval; 1.28-4.12) Conclusion : These results suggest that the decreased level of AT-III is an important prognostic factor in children with ALI and the replacement of AT-III may be considered as an early therapeutic trial.

The Effects of Global Entrepreneurship and Social Capital Within Supply Chain on the Export Performance (글로벌 기업가정신과 공급사슬 내 사회적 자본이 수출성과에 미치는 영향)

  • Yoon, Heon-Deok;Kwak, Ki-Young;Seo, Ri-Bin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.3
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    • pp.1-16
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    • 2012
  • Under the international business circumstance, global supply chain management is considered a vital strategic challenge to small and medium-sized enterprises(SMEs) suffering from deficient resources and capabilities to exploit overseas markets comparing with large corporations. That is because they can expand their business domains into overseas markets by establishing strategic alliances with global supply chain partners. Although a wide range of previous researches have emphasized the cooperative networks in the chain, most are ignoring the importance of developing relational characteristics such as trust and reciprocity with the partners. Besides, verifying the relational factors influencing firms' export performances, some studies proposed different and inconsistent factors. According to the social capital theory, which is the social quality and networks facilitating close cooperation of inter-individual and inter-organization, provides the integrated view to identify the relational characteristics in the aspects of network, trust and reciprocal norm. Meanwhile, a number of researchers shows that global entrepreneurship is the internal and intangible resource necessary to promote SMEs' internationalization. Upon closer examination, however, they cannot explain clearly its influencing mechanism in the inter-firm cooperative relationships. This study is to verify the effect of social capital accumulated within global supply chain on SMEs' qualitative and quantitative export performance. In addition, we shed new light on global entrepreneurship expected to be concerned with the formation of social capital and the enhancement of export performances. For this purpose, the questionnaires, developed through literature review, were collected from 192 Korean SMEs affiliated in Korean Medium Industries Association and Global Chief Executive Officer's Club focusing on their memberships' international business. As a result of multi-regression analysis, the social capital - network, trust and reciprocal norm shared with global supply chain partner - as well as global entrepreneurship - innovativeness, proactiveness and risk-taking - have positive effect on SMEs' export performances. Also global entrepreneurship affects positively social capital which has mediating effect partially in the relationship between global entrepreneurship and performances. These results means that there is a structural process - global entrepreneurship(input), social capital(output), and export performances(outcome). In other words, a firm should consistently invest in and develop the social capital with global supply chain partners in order to achieve common goals, establish strategic collaborations and obtain long-term export performances. Furthermore, it is required to foster the global entrepreneurship in an organization so as to build up the social capital. More detailed practical issues and discussion are made in the conclusion.

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Comparison of Efficacy of Overlapped Versus Long Eluting Stent in Acute Myocardial Infarction Patients with Diffuse Long Lesion (미만성 긴 병변이 있는 급성심근경색환자에서 긴 단일 용출 스텐트 시술과 중첩 스텐트 시술의 효과 비교)

  • Kim, Won Hyo;Kim, In Soo;Kong, Chang gi;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.319-336
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    • 2020
  • The purpose of this study was to compare the outcomes of two interventional methods, overlapping drug-eluting stents (DES) and long DES, for long-term clinical outcomes in patients with acute myocardial infarction (AMI). A total of 438 patients with AMI (65.9±11.0 years, 306 males) from June 2008 to March 2019 who had diffuse long coronary artery lesion, more than 30mm were divided into two groups; group I (overlapped DES group; n=140) and group II (long DES group; n=298). We compared the incidences of major adverse cardiac events [MACEs; cardiac death, myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST)] during 12 months between the two groups. Everolimus-eluting stent was more commonly used in group II than in group I (28.1% vs. 51.8% p<0.001). Mean lesion diameter was slightly longer in group II (3.1±0.3mm vs. 3.2±0.3mm, p=0.042), and prevalence of ACC/AHA lesion type C was higher in group I (41.7% vs. 25.4%, p<0.001). Incidences of MACEs during 12 months were higher in group I than group II (18.5% vs. 14.4%, p=0.034). The rates of cardiac death (2.1% vs. 4.4%, p=0.667), MI (5.0% vs. 2.7%, p=0.260) and stent thrombosis rate (0.7% vs. 1.7%, p=0.669) were similar between the two groups. However, TLR rate was higher in group I (10.7% vs. 5.6%, p=0.041). In multivariate logistic regression analysis, presence of diabetes mellitus [Hazard ratio (HR) 2.383, 95% confidence interval (CI) 1.332-4.260, p=0.003] and use of paclitaxel-eluting stent (HR) 2.367, 95% CI 1.371-4.086, p=0.002) were independent predictors of 12-month MACEs, without significant differences in prevalence between the two groups. In AMI patients with diffuse long lesion, TLR rate was higher in the overlapped DES group during 12-month follow-up. Presence of diabetes and use of paclitaxel-eluting stent were independent predictors of MACEs.

The Y153H Variant of the STOX1 Gene in Korean Patients with Preeclampsia

  • Kim, Shin-Young;Park, So-Yeon;Lim, Ji-Hyae;Yang, Jae-Hyug;Kim, Moon-Young;Park, Hyun-Young;Lee, Kwang-Soo;Kim, Young-Ju;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.6 no.1
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    • pp.56-61
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    • 2009
  • Purpose: Preeclampsia is a multifactorial disorder with genetic and environmental components. Recently, the STOX1 gene, identified as a candidate gene for preeclampsia in Dutch women, has been shown to be placentally expressed and subject to imprinting with preferential transmission of the maternal allele. The purpose of this study is to investigate whether there is an association between the STOX1 Y153H variation and preeclampsia in Korean pregnant women. Materials and Methods: This study involved 202 preeclamptic and 204 healthy pregnant women who were genotyped for the Y153H variant of the STOX1 gene using a commercially available SNapShot assay kit and an ABI Prism 3730 DNA Analyzer. Results: There were no significant differences in genotype frequencies of the Y153H variant of the STOX1 gene between preeclamptic patients and normal controls (P>0.05). The H allele frequency of the STOX1 Y153H variation was similar in patients with preeclampsia (87.1%) and in normal controls (86.5%). In addition, multiple logistic regression analysis showed that the YH, HH, and YH/HH genotypes were not associated with an increased risk of preeclampsia when compared to the YY genotype. Conclusion: This is the first study to characterize the Y153H variant of the STOX1 gene in Korean patients with preeclampsia. We found no differences in the genotype and allele frequencies between preeclamptic and normal pregnancies. Although limited by a relatively small sample size, our study suggests that the STOX1 Y153H variation is not associated with the development of preeclampsia in Korean pregnant women.

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The Relationship between Noise Exposure Level in Worksite and Workers' Stress Symptoms (산업장의 소음폭로수준과 근로자의 스트레스 증상간의 관련성)

  • Park, Kyung-Ok;Lee, Myung-Sun
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.239-254
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    • 1996
  • Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modem diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the $20\sim29years$ old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 100,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked $1\sim5$ years in the factories were 33.0%. Those who were much for them workload were 43.9% and who worked more than 8 hours a day were 73.9%. Those who were disatisfied with their job and pay were 31.9% and 50.6%. The workers who responsed ventilation condition of their worksites were bad were 51.9% and the dissatisfed with working environment of their worksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.1%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to $80\sim90dB$ were 30.3%, $90\sim100dB$ were 26.4% and $50\sim70dB$ were 19.2%. 5. Workers' stress symptoms were significantly related to marital status and their monthly income(p<0.05). Workers who were single and had lower monthly income showed higher PSI (Psychiatric Symptom Index) scores than those who were married and had higher monthly income. Higher PSI scores were also significantly related to $1\sim2$ days hight-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSI scores were significantly related to severe tinnitus and perceived hearing losso(p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSI scores(p<0.01). Workers who reported that they did not feel they need earplugs showed. significantly higher PSI scores (p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSI scores(p<0.01). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSI subparts were reported; Anxiety, Anger, Depression, and Cognitive disorder(p<0.001). 5. According to the results of stepwise multiple regression analysis, factors affecting workers' PSI scores were perceived hearing loss$(R^2=0.160)$, noise exposure level in worksite$(R^2=0.110)$, realtionship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total $R^2$ of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.

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Flavor Characteristics of Kakdugi by Radish Cultivars and Seasons (무 품종 및 계절에 따른 깍두기의 향미특성)

  • Kim, Mee-Ree;Jhee, Ok-Hwa;Yoon, Hwa-Mo;Yang, Cha-Bum
    • Korean Journal of Food Science and Technology
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    • v.28 no.4
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    • pp.762-771
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    • 1996
  • Chemical and sensory characteristics of kakdugi which was prepared with various radish cultivars and harvesting seasons were analyzed during 7-day storage. Average pH of small radish cultivar kakdugi was higher than that of large ones, and total acidity was lower in small ones. Reducing sugar content was the highest in kakdugi of autumn radish. Organic acids such as lactic, succinic and fumaric acid analyzed by GC increased until the third day of fermentation, whereas volatile isothiocyanates analyzed by GC/MS continued to decline. There was a significant difference in flavor characteristics of large radish kakdugi across seasons, in contrast to no significant difference in those of small radish kakdugi except sweet taste and reducing sugar content in which interaction existed between season and cultivar. Score of overall acceptability was higher in small radish than large ones with Dongja showing the highest score of overall acceptability. Overall acceptability of autumn Dongja kakdugi was positively correlated with radish kakdugi odor and sour odor, respectively, but negatively with total acidity, lactic acid content, sweet taste and pungency, respectively. By multiple regression analysis, overall acceptability in spring Dongja kakdugi is expressed as a function of overall acceptability = -0.1115 + 1.2519 savory taste + 1.5159 malic acid -0.0054 total isothiocyanate + ${\varepsilon}$.

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GnRH Agonist Stimulation Test (GAST) for Prediction of Ovarian Response in Controlled Ovarian Stimulation (COH) (난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구)

  • Kim, Mee-Ran;Song, In-Ok;Yeon, Hye-Jeong;Choi, Bum-Chae;Paik, Eun-Chan;Koong, Mi-Kyoung;Song, Il-Pyo;Lee, Jin-Woo;Kang, Inn-Soo
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.163-170
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    • 1999
  • Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

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The Characteristics of Blood Pressure Control in Chronic Renal Failure Patients Treated with Peritoneal Dialysis (복막 투석중인 만성 신부전 환자의 혈압 조절에 관한 연구)

  • Jung, Hang-Jae;Bae, Sung-Hwa;Park, Jun-Bum;Jo, Kyoo-Hyang;Kim, Young-Jin;Do, Jun-Young;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.333-341
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    • 1999
  • Background and Methods: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). Results: The results were as follows; 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantly decreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p<0.05). 3) After changing the modality from hemodialysis to peritoneal dialysis, MAP(mmHg, from $107.0{\pm}4.5$ to $98.6{\pm}8.8$, p<0.05), antihypertensive drug requirements(from $5.6{\pm}2.6$, to $2.0{\pm}2.5$, p<0.01) and erythropoietin dosages(Uint/week, from $4600{\pm}2660$ to $2000{\pm}1630$, p<0.05) were decreased. 4) Multiple logistic regression analysis showed that MAP(p<0.01) and daily ultrafiltration volume(p<0.05) can contribute to the determination of antihypertensive drug requirements. However the relationship between antihypertensive drug requirements and PET results or dialysis adequacy indices(weekly Kt/V, weekly creatinine clearance) was not revealed. Conclusion: In conclusion, the prescription of antihypertensive drugs should be considered according to daily ultrafiltration volume, especially during first year after initiating PD, and follow-ups for over a year may be needed.

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Blood Lead and ZPP Concentrations of Underground Parking Lot Workers (지하주차장 근무자의 혈중 연 및 Zinc Protoporphyrin 농도)

  • Jung, Tae-Heum;Jeon, Man-Joong;Hwang, Tae-Yoon;Kim, Chang-Yoon;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.15 no.2
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    • pp.224-236
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    • 1998
  • A study was conducted to investigate the blood lead and zinc protoporphyrin(ZPP) concentrations of the underground parking lot workers who exposed to vehicular exhaust aerosols which contained lead. The blood samples were collected from 25 study subjects of underground parking lot and from 33 controls in Taegu, from July to October, 1997. And also the related factors to the blood lead and ZPP concentrations were investigated. Blood lead concentration and ZPP concentration were measured by flameless furnace atomic absorption spectrophotometer (1L.551) and hemetofluorometer, respectively. The mean blood lead concentrations of study subjects and controls were $23.10{\pm}20.77{\mu}g/dl$ and $12.99{\pm}12.71{\mu}g/dl$, respectively(p<0.05), and the mean blood ZPP concentrations of study subjects and controls were $40.72{\pm}9.46{\mu}g/dl$ and $38.21{\pm}10.97{\mu}g/dl$, respectively. No significant correlations were observed between the blood lead concentration of the study subjects and their job duration and between blood ZPP concentration of the study subjects and their job duration. There were no statistically significant differences in the blood lead concentration and the blood ZPP concentration of smokers and nonsmokers. In multiple regression analysis on blood lead concentration of the study subjects and controls, occupation was a only significant dependent variable. In case of bood ZPP concentration, age was a only significant dependent variable in the study subjects and controls.

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