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Characteristics and outcomes of patients with septic shock who transferred to the emergency department in tertiary referral center: multicenter, retrospective, observational study (상급종합병원 및 종합병원 응급실로 전원된 패혈성 쇼크 환자의 특성과 예후: 다기관 후향적 관찰연구)

  • Kim, Min Gyun;Shin, Tae Gun;Jo, Ik Joon;Kim, Won Young;Ryoo, Seung Mok;Chung, Sung Phil;Beom, Jin Ho;Choi, Sung-Hyuk;Kim, Kyuseok;Jo, You Hwan;Kang, Gu Hyun;Suh, Gil Joon;Shin, Jonghwan;Lim, Tae Ho;Han, Kap Su;Hwang, Sung Yeon;Korean Shock Society (KoSS)
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.465-473
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    • 2018
  • Objective: We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center. Methods: This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality. Results: A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4-9 vs. 6; IQR, 4-8; P<0.001). Mechanical ventilator (29% vs. 21%, P<0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78-1.28; P=0.999) for the transferred group compared with the non-transferred group. Conclusion: The transferred group showed higher severity and needed more organ support procedures than the non-transferred group. However, inter-hospital transfer did not affect in-hospital mortality.

Effects of the Low Plane of Nutrition on Carcass and Pork Quality of Finishing Pigs (저영양 비육돈 사양이 도체 및 돈육 품질에 미치는 영향)

  • Choi, Jung Seok;Yang, Bo-Seok;Kim, Myeong Hyeon;Lee, Kwang Ho;Jung, Hee Jun;Jin, Sang Keun;Song, Young-Min;Lee, Chul Young
    • ANNALS OF ANIMAL RESOURCE SCIENCES
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    • v.29 no.4
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    • pp.172-182
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    • 2018
  • The present study was undertaken to examine if the carcass and pork quality of finishing pigs reared on a low plane of nutrition (LPN) could be improved compared with that of the pigs finished on a high plane of nutrition (HPN). Sixty-eight crossbred (LYD) barrows and 68 LYD gilts weighing approximately 50 kg were fed a diet containing 3.54 Mcal DE/kg with 1.00% lysine (HPN) or 3.02 Mcal DE/kg with 0.68% lysine (LPN) in eight pens up to approximately 120 kg and slaughtered. The belly, loin, ham, and Boston butt were cut out from a total of 20 carcasses, after which physicochemical and sensory quality attributes of the belly and the representative muscle of each of the loin, ham, and Boston butt were evaluated. The ADG, gain:feed ratio, and backfat thickness were less for LPN than for HPN (p<0.05). The cooking loss, hardness, and chewiness values for the Boston butt were less for LPN vs. HPN. In sensory evaluation for fresh meat (muscle), the subjective quality scores were greater for LPN vs. HPN in color, marbling, and acceptability for the loin, the muscle:fat balance score for the belly tending to be greater for LPN (p<0.10). In addition, LPN was superior to HPN in the flavor and juiciness in sensory evaluation for cooked ham. In conclusion, the present results suggest that the carcass and pork quality of finishing pigs could be improved with reduced growth performance by using LPN.

Herbal Medicine for the Treatment of Rosacea: A Systematic Review and Meta-analysis of Randomized Controlled Trials (주사(Rosacea)의 한약 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Kang, Eun-Jeong;Kam, Eun-Young;Kim, Seo-Hee;Yoon, Seok-Yeong;Jeon, Seok-Hee;Choi, Jung-Wha;Kim, Jong-Han;Park, Soo-Yeon;Jung, Min-Yeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.3
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    • pp.27-54
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    • 2021
  • Objectives : This review was conducted to validate the effectiveness and safety of herbal medicine combined with conventional therapy for rosacea. Methods : Randomized controlled trials(RCTs) reporting the effects of herbal medicine treatment on rosacea were searched through eight electronic databases from 2016 to March 17, 2020. This study collection and data extraction were performed by two independent reviews. The Cochrane risk-of-bias tool was used for the evaluation of the risk of bias in all included RCTs. Mean differences(MD) and Risk ratio(RR) of 95% Confidence intervals(Cls) were calculated and data synthesis was conducted using Review Manager(RevMan, ver.5.4) Results : Eighteen RCTs were included and all trials compared the combined therapy of herbal medicine with conventional western therapy to conventional therapy alone. The effective rate of the combination of herbal medicine with western medicine(RR 1.20, 95% CI : 1.13-1.28, p<0.00001, I2=0%), the effective rate of the combination of herbal medicine with laser-based therapy(RR 1.12, 95% CI : 1.04-1.21, p=0.004, I2=18%) and the effective rate of the combination treatment group using herbal medicine, western medicine and external drugs were all statistically higher that of the control group(RR 1.19, 95% CI : 1.11-1.28, p<0.00001, I2=0%). The score of non transient erythema(MD -0.36, 95% CI : -1.01 0.29, p=0.27, I2=93%), flushing(MD -0.69, 95% CI : -0.97, 0.41, p<0.00001, I2=32%), papules or pustules(MD 0.10, 95% CI : -0.15, 0.35 p=0.44, I2=0%) were also seen in the herbal medicine and western medicine combination group. The overall risk of bias of the included studies was some concerns. No serious adverse effects were observed. Conclusions : This review found the safety and effectiveness of the combined therapy of herbal medicine with conventional western therapy for rosacea.

Development of Contents for the Activities of Daily Living Training for Life Care - Korean Version (라이프케어를 위한 한국형 일상생활활동훈련치료 콘텐츠 개발)

  • Lee, Chun-Yeop;Park, Young-Ju
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.529-538
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    • 2020
  • This study aims to develop of contents for the activities of daily living training - Korean version that reflexes the domestic situation and can be applied to clinical practice. For contents development, a Delphi survey was conducted with 13 experts. In the first Delphi survey, 133 items of activities of daily living training are derived based on previous studies, and then the extracted items are asked to group of experts, and the derived items are answered for actual domestic clinical application. In the second survey, 118 items were added by excluding items with a low content validity ratio (CVR) including the results of the first survey, and adding items that can be derived from other opinions. In the 3rd survey, while presenting the 2nd Delphi survey items as they are, it provides an opportunity to change their opinions by presenting their 2nd response and the 2nd average score of other expert panels, and adding appropriateness and importance together. The data were analyzed to obtain the mean, standard deviation, interquartile range, CVR, convergence, and consensus. Finally, a total of 69 items were selected and 49 items were excluded so that 105 items for CVR 0.54 or higher, 111 items for convergence degree 0.50 or lower, and 70 items for continuity degree 0.75 or higher. Sexual activity, care of others, care of pets, and child rearing are difficult to apply socially and culturally, driving and community mobility cannot be performed within the clinical room, and home establishment and management may have different roles depending on gender, and religious spiritual activities and expression are so personal. For these reasons, these items were found to have low importance or suitability. This study can be usefully used as an indicator on the activities of daily living training - Korean version in clinic or community setting.

Association between seafood intake and frailty according to gender in Korean elderly: data procured from the Seventh (2016-2018) Korea National Health and Nutrition Examination Survey (한국 노인의 성별에 따른 수산물 섭취 수준과 노쇠 위험성의 상관성 연구: 제 7기 (2016-2018) 국민건강영양조사 자료를 이용하여)

  • Won Jang;Yeji Choi;Jung Hee Cho;Donglim Lee;Yangha Kim
    • Journal of Nutrition and Health
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    • v.56 no.2
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    • pp.155-167
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    • 2023
  • Purpose: This study investigates the association between seafood consumption and frailty according to gender in the Korean elderly. Methods: Cross-sectional data from the Seventh (2016-2018) Korea National Health and Nutrition Examination Survey was procured for this study. Data from 3,675 subjects (1,643 men and 2,032 women) aged ≥ 65 years were analyzed. Levels of seafood intake were assessed by a one-day 24-hour dietary recall, and subjects were classified into three tertiles by gender according to frailty phenotype: robust, pre-frail, and frail. Multinomial logistic regression analysis was performed to clarify the association between seafood consumption and frailty for each gender. Results: The prevalence of frailty was determined as 13.4% for men and 29.7% for women. Participants with a higher seafood intake had higher intakes of grains, fruits, and vegetables, while the intake of meat was significantly lower. In both men and women, the group with higher seafood intake showed higher energy and micronutrient intakes. The frail prevalence and frailty score were significantly low in the highest tertiles of seafood consumption compared to the lowest tertile in men and women (p < 0.001). After adjusting for confounder, the highest tertile of seafood consumption showed a decreased risk of frailty compared to the lowest tertile only in women (hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.32-0.78; p-trend = 0.008 vs. HR, 0.52; 95% CI, 0.32-0.83; p-trend = 0.008; respectively). Conclusion: Results of this study suggest that seafood consumption potentially decreases the risk of frailty in the elderly.

Ecological Network on Benthic Diatom in Estuary Environment by Bayesian Belief Network Modelling (베이지안 모델을 이용한 하구수생태계 부착돌말류의 생태 네트워크)

  • Kim, Keonhee;Park, Chaehong;Kim, Seung-hee;Won, Doo-Hee;Lee, Kyung-Lak;Jeon, Jiyoung
    • Korean Journal of Ecology and Environment
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    • v.55 no.1
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    • pp.60-75
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    • 2022
  • The Bayesian algorithm model is a model algorithm that calculates probabilities based on input data and is mainly used for complex disasters, water quality management, the ecological structure between living things or living-non-living factors. In this study, we analyzed the main factors affected Korean Estuary Trophic Diatom Index (KETDI) change based on the Bayesian network analysis using the diatom community and physicochemical factors in the domestic estuarine aquatic ecosystem. For Bayesian analysis, estuarine diatom habitat data and estuarine aquatic diatom health (2008~2019) data were used. Data were classified into habitat, physical, chemical, and biological factors. Each data was input to the Bayesian network model (GeNIE model) and performed estuary aquatic network analysis along with the nationwide and each coast. From 2008 to 2019, a total of 625 taxa of diatoms were identified, consisting of 2 orders, 5 suborders, 18 families, 141 genera, 595 species, 29 varieties, and 1 species. Nitzschia inconspicua had the highest cumulative cell density, followed by Nitzschia palea, Pseudostaurosira elliptica and Achnanthidium minutissimum. As a result of analyzing the ecological network of diatom health assessment in the estuary ecosystem using the Bayesian network model, the biological factor was the most sensitive factor influencing the health assessment score was. In contrast, the habitat and physicochemical factors had relatively low sensitivity. The most sensitive taxa of diatoms to the assessment of estuarine aquatic health were Nitzschia inconspicua, N. fonticola, Achnanthes convergens, and Pseudostaurosira elliptica. In addition, the ratio of industrial area and cattle shed near the habitat was sensitively linked to the health assessment. The major taxa sensitive to diatom health evaluation differed according to coast. Bayesian network analysis was useful to identify major variables including diatom taxa affecting aquatic health even in complex ecological structures such as estuary ecosystems. In addition, it is possible to identify the restoration target accurately when restoring the consequently damaged estuary aquatic ecosystem.

Real data-based active sonar signal synthesis method (실데이터 기반 능동 소나 신호 합성 방법론)

  • Yunsu Kim;Juho Kim;Jongwon Seok;Jungpyo Hong
    • The Journal of the Acoustical Society of Korea
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    • v.43 no.1
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    • pp.9-18
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    • 2024
  • The importance of active sonar systems is emerging due to the quietness of underwater targets and the increase in ambient noise due to the increase in maritime traffic. However, the low signal-to-noise ratio of the echo signal due to multipath propagation of the signal, various clutter, ambient noise and reverberation makes it difficult to identify underwater targets using active sonar. Attempts have been made to apply data-based methods such as machine learning or deep learning to improve the performance of underwater target recognition systems, but it is difficult to collect enough data for training due to the nature of sonar datasets. Methods based on mathematical modeling have been mainly used to compensate for insufficient active sonar data. However, methodologies based on mathematical modeling have limitations in accurately simulating complex underwater phenomena. Therefore, in this paper, we propose a sonar signal synthesis method based on a deep neural network. In order to apply the neural network model to the field of sonar signal synthesis, the proposed method appropriately corrects the attention-based encoder and decoder to the sonar signal, which is the main module of the Tacotron model mainly used in the field of speech synthesis. It is possible to synthesize a signal more similar to the actual signal by training the proposed model using the dataset collected by arranging a simulated target in an actual marine environment. In order to verify the performance of the proposed method, Perceptual evaluation of audio quality test was conducted and within score difference -2.3 was shown compared to actual signal in a total of four different environments. These results prove that the active sonar signal generated by the proposed method approximates the actual signal.

Elevated On-Treatment Diastolic Blood Pressure and Cardiovascular Outcomes in the Presence of Achieved Systolic Blood Pressure Targets

  • Dae-Hee Kim;In-Jeong Cho;Woohyeun Kim;Chan Joo Lee;Hyeon-Chang Kim;Jeong-Hun Shin;Si-Hyuck Kang;Mi-Hyang Jung;Chang Hee Kwon;Ju-Hee Lee;Hack Lyoung Kim;Hyue Mee Kim;Iksung Cho;Dae Ryong Kang;Hae-Young Lee;Wook-Jin Chung;Kwang Il Kim;Eun Joo Cho;Il-Suk Sohn;Sungha Park;Jinho Shin;Sung Kee Ryu;Seok-Min Kang;Wook Bum Pyun;Myeong-Chan Cho;Ju Han Kim;Jun Hyeok Lee;Sang-Hyun Ihm;Ki-Chul Sung
    • Korean Circulation Journal
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    • v.52 no.6
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    • pp.460-474
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    • 2022
  • Background and Objectives: This study aimed to investigate the association between cardiovascular events and 2 different levels of elevated on-treatment diastolic blood pressures (DBP) in the presence of achieved systolic blood pressure targets (SBP). Methods: A nation-wide population-based cohort study comprised 237,592 patients with hypertension treated. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and stroke. Elevated DBP was defined according to the Seventh Report of Joint National Committee (JNC7; SBP <140 mmHg, DBP ≥90 mmHg) or to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) definitions (SBP <130 mmHg, DBP ≥80 mmHg). Results: During a median follow-up of 9 years, elevated on-treatment DBP by the JNC7 definition was associated with an increased risk of the occurrence of primary endpoint compared with achieved both SBP and DBP (adjusted hazard ratio [aHR], 1.14; 95% confidence interval [CI], 1.05-1.24) but not in those by the 2017 ACC/AHA definition. Elevated on-treatment DBP by the JNC7 definition was associated with a higher risk of cardiovascular mortality (aHR, 1.42; 95% CI, 1.18-1.70) and stroke (aHR, 1.19; 95% CI, 1.08-1.30). Elevated on-treatment DBP by the 2017 ACC/AHA definition was only associated with stroke (aHR, 1.10; 95% CI, 1.04-1.16). Similar results were seen in the propensity-score-matched cohort. Conclusion: Elevated on-treatment DBP by the JNC7 definition was associated a high risk of major cardiovascular events, while elevated DBP by the 2017 ACC/AHA definition was only associated with a higher risk of stroke. The result of study can provide evidence of DBP targets in subjects who achieved SBP targets.

Association between physical activity and periodontitis according to depression among Korean adults (한국 성인의 우울증 여부에 따른 신체활동과 치주질환 간 관련성)

  • Hye-Rim Jeon;Soo-Myoung Bae;Hyo-Jin Lee
    • Journal of Korean Dental Hygiene Science
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    • v.7 no.1
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    • pp.69-81
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    • 2024
  • Background: This study aimed to investigate the association between physical activity and periodontitis based on depression status in a representative sample of Korean adults. Methods: A total of 12,689 subjects who participated in the 7th Korea National Health and Nutrition Examination Survey (2016-2018) were examined. Depression was defined as a PHQ-9 score ≥ 10. Periodontal status was assessed using the community periodontal index, with periodontitis defined as a code ≥ 3. Physical activity categories were divided into a physical activity group and a non-physical activity group, considering the number of days and minutes spent on moderate and vigorous activities. Moderate activity was defined as causing slight breathlessness or a slightly elevated heart rate, while vigorous activity was defined as causing significant breathlessness or a rapid heart rate. Multivariable logistic regression analyses were adjusted for sociodemographic variables (age, sex, education level, and household income), oral and general health behaviors (use of floss and interdental proximal brush, current smoking), and systemic health status (diabetes and hypertension). All analyses utilized a complex sampling design, and subgroup analysis was performed to estimate associations stratified by depression (PHQ-9 ≤ 9 and ≥ 10). Results: Multivariable regression analysis revealed that among participants with depression, those who did not engage in physical activity were 2.65 times more likely to have periodontitis (odds ratio = 2.65, 95% confidence interval = 1.17-6.01). Conclusion: The study findings suggest that individuals who participate in any form of physical activity may be significantly less likely to develop periodontitis, particularly within the group experiencing depression.

Effect of Health Promotion Programs in Schoolchildren (초등학교 학생을 대상으로 한 건강증진 프로그램의 효과)

  • Yoo, Joong-Sun;Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Seok-Beom;Choi, Kwang-Hae;Kim, Mee-Kyung
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.397-411
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    • 2000
  • The present study was conducted to analyze the degree of changes in knowledge and attitude toward health, arid health promoting activities after providing health education intervention for a year to elementary school children, to examine the factors effecting knowledge, attitude and health promoting practices for obesity and diet, and to analyze whether changes are present in health level according to changes in knowledge on health and health promoting activities. After conducting a pre-survey rio 354 subjects of 3rd and 4th grade students and their mothers in the city area of Kyungju, in April, 1999, 301. responses with the responding rate of 85% were obtained. Final analysis was done with 231 pairs of a student and his/her mother who could be followed up after a year among 301 pairs of the respondents, excluding those students who transferred, those who were excused from school early, those who did not take abdominal fat measurements, and those students and mothers respondents whose survey was incomplete. Based on the changes before and after the intervention, the scores on knowledge about obesity and diet showed a significant difference in normal weight group, and the scores on the attitude toward obesity and diet increased significantly in obesity group but decreased significantly in normal weight group(p<0.01). The scores of practicing health promoting activities were significantly increased in both groups, and although the waist-hip ratio (WHR) did not change in obesity group, the rate increased significantly in normal weight group(p<0.01). As for changes on the knowledge of obesity and diet before and after the intervention while dividing the scores into 3 levels based on the scores of the pre-survey and compared to changes in the scores one year after, in the case of the changes in the scores in the 1st third, the score on the knowledge about obesity and diet changed from 1.3 in the pre survey to 3.7 after the intervention, showing significant increase(p<0.01) The scores of practicing health promoting activities for obesity and diet were significantly increase in all three levels(p<0.01), and the degree of changes in the scores was 7.0 points in the 1st third, 4.4 points for the and third and 1.8 points for the 3rd third, showing a significant difference among the three levels(p<0.01). It was shown that the increase in BMI in those students whose mothers have the education level higher than university was significantly higher than the increase in BMI in those students whose mothers have the education level under high school, and those students whose mothers are in their 30's showed higher changes in practicing health promoting activities for obesity and diet. When the scores of mothers' knowledge and attitude toward obesity and diet were compared by dividing the scores into tertile, the score of students' knowledge changed significantly according to the scores of mothers' attitude toward obesity and diet. In multiple regression analysis on changes in the scores of knowledge about obesity and diet, the student variables of the degree of awareness on the seriousness of obesity, and the scores of previous knowledge on diet and obesity were selected the significant variables, and among the mother variables, the degree of guiding the child on diet and the education level were the significant variables. In multiple regression analysis to analyze the factors effecting changes in the attitude toward obesity and diet, the student variables of the BMI, scores of previous knowledge on obesity and diet, and scores on the previous attitude toward obesity and diet were shown to be significant. In multiple regression analysis on the factors effecting changes in health promoting activities for obesity and diet, the student variables of the BMI, scores on the previous attitude toward obesity and diet, and changes in the scores of obesity and diet were selected the significant variables.

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