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Initial $^{99m}Technetium-dimercaptosuccinic$ Acid (DMSA) Renal Scan Finding and Vesicoureteral Reflux as Predicting Factor of Renal Scarring (신반흔 예측인자로서 초기 $^{99m}Technetium-dimercaptosuccinic\;Acid$ 신주사 소견과 방광요관 역류의 유무 및 정도)

  • Lee Soo-Yeon;Lim So-Hee;Lee Dae-Yeol
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.44-51
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    • 2003
  • Purpose : Acute pyelonephritis in children may result in permanant renal damage which later in life may lead to hypertension and renal failure. The purpose of this study was to evaluate the factors that might be useful for predicting the development of renal scar in children with urinary tract infection(UTI). Methods : We retrospectively reviewed 442 patients with UTI who were admitted to the Department of Pediatrics of Chonbuk National University Hospital, during the period from April 1992 to March 2002. The patients were divided into two groups according to the presence of renal scar on the follow-up DMSA renal scan, and we compared the factors associated with renal scarring between the two groups. Results : There were no significant differences in sex, causative organism and acute phase reactants between the groups with and without renal scar. The age at diagnosis was significantly higher in the renal scar group compared to that without scar. Of the 60 patients with renal scar, 78% had vesicoureteral reflux(VUR), but 13% of patients without scar had VUR. Furthermore, the severity of VUR was significantly correlated with renal scar formation. 53% showed multiple cortical defects on the initial DMSA renal scan, compared to 32% in the non-scar group. In addition, 76% of patients showing multiple cortical defects on the initial DMSA renal scan with VUR had renal scar. Conclusion : The presence and grade of VUR, and findings on the initial DMSA renal scan would contribute to predict risk of renal scar formation in children with UTI.

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Comparative Clinical Study between Oriental Medicine and Oriental-western Medicine Treatment on Facial Nerve Paralysis (구안와사(口眼喎斜)에 대한 한의(韓醫) 및 한(韓)·서의(西醫) 협진(協診) 치료(治療)의 임상(臨床) 관찰(觀察))

  • Kang, Mi-Jung;Kim, Kee-Hyun;Hwang, Hyeon-Seo
    • Journal of Acupuncture Research
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    • v.17 no.1
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    • pp.55-66
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    • 2000
  • The following results have been obtaind after examing 72patients with facial paralysis who were hospitalzed and treated through the time period of December 1st, 1996 to November 30th, 1999 at the Department of Acupuncture and Moxibustion of Seoul Oriental Medicine, Kyungwon University. During the examination, those 72 patients were divided into two groups, and One group was treated by oriental-western treatment, the other group was treated by oriental treatment. Oriental treatments were acupuncture and moxibustion, herb medicine, physical treatment and hygienic treatment. The one of main western treatments is steroid therapy. The results were obtained as follows : 1. In regard to signs at the first medical examination, lacrimation was showed highest number and facial paralysis, dysgeusia, hyperacusis were showed in numerical order. 2. In regard to prescription of oriental herb medicine, Kamissangbotang(加味雙補湯) was prescribed in greatest numbers and Boyangwhanotang(補陽還五湯), Kamiboiktang(加味補益湯), Ligigepungtang(理氣祛風湯) were prescribed in numerical order. 3. In regard to treatment number, 10~19 times for treatment was showed highest number and 1~9 times, 20~29 times, 40~49 times were showed in numerical order . 4. In regard to mean treatment times about injury region and main sign, the effect of oriental-western treatment was showed as follows: lacrimal gland disorder, hyperacusis, dysgeusia, facial paralysis were treated for 15.1, 27, 13.2 and 21.4 times, repectively. The effect of oriental treatment was showed as follows: lacrimal gland disorder, hyperacusis, dysgeusia, facial paralysis were treated for 34.8, 22.1, 33.8 and 16.3 times, respectively. 5. In regard ta the effect of treatment about injury region and main sign, oriental-western treatment was showed as follows: cases of lacrimal gland disorder were showed 1 of excellent case, 1 of fair case, 5 of good cases. In hyperacusis patients, there was showed 1 of fair case. In dysgeusia patients, there was showed 1 of excellent case, 3 of fair cases, 1 of good case. In facial paralysis, there were showed 5 of fair cases. Oriental treatment was showed as follows: In lacrimal gland disorder, the excellent were 4 cases, the fair were 10 cases, the good were 3 cases and the poor were 4 cases, In hyperacusis, the fair were 5 cases, the poor 2 cases. In dysgeusia, the excellent were 4 cases, the fair were 1 case, the good were 1 case and the poor was 1 case, In facial paralysis, the excellent were 9 cases, the fair were 4 cases, the good 3 cases and the poor were 3 cases. 6. The effect of total treatment was as follows: 30 cases were showed fair effect, 19 cases were showed excellent effect, 13 cases were showed good effect and 10 cases were showed poor effect. 7. In regard to attack factor, overlabour was showed highest number and wind-cold, mental stress, trauma, ear disease, common cold, dental diseae, reason unknwon were showed in numerical order. 8. In regard to premonitory symptoms, non significant symptoms were in 38 cases, the pain of peri-stylomastoid region were in 38 cases and headache, dysaesthesia of periorbit, dysgeusia, stomatitis, eyelid tic were showed in numerical order. 9. In regard to sex, male were 33 cases and female were 39 cases. The distribution of age was disclosed that thirty, forty, fifty, seventy, sixty, twenty and below twenty years were revealed in turn. Sex and paralytic side were showed as follows: male-left were 15 cases, male-right were 18 cases, female-left were 19 cases and female-right were 19 cases. In regard to attack frequence in month, March was showed highest number and January, April, May, August, October, etc were showed in numerical order. In regard to attack frequence in season, spring was showed highest number and winter, summer, fall were showed in numerical order, but attack frequence between four seasons wasn't showed significant difference.

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Angiotensin Converting Enzyme Gene Polymorphism in Alport Syndrome (알포트증후군 환자에서 안지오텐신전환효소 유전자 다형성의 의의)

  • Kim Ji-Hong;Lee Jae-Seung;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.18-25
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    • 2004
  • Purpose : Alport syndrome is clinically characterized by hereditary progressive nephritis causing ESRD with irregular thickening of the GBM and sensory neural hearing loss. The mutations of type IV collagen gene(COL4A5) located on the long arm of X chromosome is considered responsible for most of the structural abnormalities in the GBM of Alport patients. Since no definite clinical prognostic predictor has been reported in the disease yet, we designed this study to evaluate the significance of genetic polymorphism of the angiotensin converting enzyme in children with Alport syndrome as a prognostic factor for disease progression. Methods : ACE I/D genotype were examined by PCR amplification of the genomic DNA in 12 patients with Alport syndrome and 12 of their family members. Alport patients were divided into two groups; the conservative group, those who had preserved renal function for more than 10 years of age, the early CRF group, those who had progressed to CRF within 10 years of age. Results : The mean age of onset was $3.45{\pm}2.4$ years in the conservative group, $4.4{\pm}1.2$ years in the early CRF group. Sex ratios were 5:3 and 2:1 in each group. Among 12 cases of patients, 4 cases were in early CRF group and their mean duration of onset to CRF was 4.5 yews(8.9 years of age). Eight patients(67%) were in the conservative group and they had normal renal function for more than 10 years of age(mean duration of renal preservation was 10.6 years). The incidence of II type ACE gene were in 25.0%(3 cases), ID type in 41.7%(5 cases), DD type in 33.3%(4 cases). There was no significant difference between Alport patient and normal control(II type 44.3%, ID type 40.9%, DD type 14.8%). The incidence of DD type of early CRF group were higher than that of the conservative group(75% vs 12.5%)(p<0.05). There was no difference in ACE gene polymorphism between normal Alport family members and control group. Conclusion : Even though there was no significant difference of ACE polymorphism between Alport patients and the normal control group, the incidence of DD type is significantly increased in early CRF group which means DD type of ACE polymorphism has a possibility of being a predictor for early progression to CRF in Alport patients.

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An Investigation on the self-consciousness Symptoms of the Clerical Workers attendant upon Office Automation (사무 자동화에 따른 사무직 근로자의 건강과 연관된 자각 증상에 대한 조사연구)

  • Jung, Mi Wha
    • Korean Journal of Occupational Health Nursing
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    • v.3
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    • pp.54-70
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    • 1993
  • According as the automation of clerical work(OA ; Office Automation) develops, the use of VDT(Visual or Video Display Terminal) is increasing suddenly. But, in proportion to the spread of office automation(OA tendency), the self-conciousness syptom attendant upon the work is appearing also (Kim, Jung Tae, Lee, Young Ook, 1990). The apparatuses of office enable the clerical workers to be convenient and perform mass businesses. But, they are increasing the opportunity to be exposed to VDT syndrom, techno stress, computer terminal disease, pain by muscle strain(RSI), bradycausia of noise nature, and electromagnetic waves, etc. which are referred to as the new type of occupational diseases to the workers. It is the real situation that the workers to use VDT is complaining of the physical inconvenience sense in the recent newspaper and literature, it is the point of time that the sydrome to come from VDT use and computer terminal disease, etc. must be classified into the occupational disease(Lee, Kwang Young 1990, Lee, Kyoo Hak 1990, Lee, Won Ho 1991, Lee, Si Young 1991, Lee, Joon 1991, Choi, Young Tae 1991, Heo, Seung Ho 1989). In addition, it is the real situation that the scientifitic study result about the scope that electromagnetic waves has influence on the human body has not been suggested yet, and criticism on the stable exposure permission standard about electromagnetic waves to be emitted from VDT and on the problem in the health about electromagnetic waves is continuing. (IEEE Spectrum, 1990). In addition according to the experience of nursery business of industry field, it is the real situation that the patients who consult complaining of physical and mental inconvenience sence, among the users of apparatus of office automation, are reaching 10% of the patients coming to doctor's room. Therefore, it is necessary to confirm the self-consciousness symptom that the clerical workers complain of multilaterally with the actual state examination about the use of the apparatuses of offices automaton. Thus, this study was tried as th basic data for the cosultation and education for the maintenance and furtherance of the health of workers as the nurse of industry field, by confirming the contents of self-consciousness symptom attendant upon the use of the apparatus for office outomation making the financial institution in which the spparatus for office automation in most frequently used as the subject, and by examining whether there is the difference according to the subject of study, the data were collected, by using the questionnaire method, making 200 workers who consented to the study participation as the subject, among the persons who have spent over 3 months since they used the apparatuses for office automation and didn't receive the treatment in hospital due to the clerical disease for recent 3 years. The period of data collection was from Oct. 9, 1991 to Oct. 12. As for the measurement instrument about the complaint if self-consciousness symptom attendant upon the use of apparatuses fo office automation, the question item on the complaint symptom of health problem attendant upon the treatment of VDT that Kim(1991) developed and on CMI health problem and the question items on the fatigue degree due to industry were used by previous examination to 25 persons. Collected data were analyzed with the statistical method such as percentage, arithmetic mean, Person correlation coeffient, Kai square verfication, t-test, ANOVA, etc. by using SPSS/PC+ program, and the result is as follows : 1. The self-consciousness symptom that the clerical workers complained of most frequetly appeared high in 'My eyes are tired'(99.4%), 'I feel fatigue and weariness'(99.4%), 'I feel that my head is heavy5(90.0%), 'eyesight fell'(88.8%), 'I have a stiff neck'(88.8%), 'I fell pain in the shoulder'(85.0%), 'I feel cold and painful in the eyes'(76.9%), 'I feel the dry sense of eyeball'(76.2%), 'My nerves are edgy, and I an fretful, (75.6%), 'I feel pain in the waist'(73.2%) and 'I fell pain in the back'(72.8%). It emerged that the subject use the apparatuses for office automation complained of self-consciousness symptoms related to visual symptoms and musculoskeletal symptoms. 2. As for the general feature of examination subjects, the result to see the distribution by classifying into sex, age, school career, use career of apparatuses for office automation, skillfulness degree of the use of apparatus for office automation, use hours of the apparatuses for office automation per 1 day, type of business of the apparatus for office automation, rest hours during the use of apparatus for office automation, satifaction degree of business of office automation, and work circumstance, etc. emerged as follows : As for the sex of subjects, the distribution showed that men were 58.8% and women were 41.3%, Age was average 26.9. As the distribution of school career, the distribution showed that4below the graduation of high school' was 58.8%, 'graduation from junior college-university' was 35.0%, and 'over graduate school' was 6.3%. In the question to ask the existence or non-existence of experience of health consultation in connection with the work of office automation, the response that I had the consultation exprience and I feel the necessity emergerd as 90.1% And, the case that the subject who didn't wear the glasses or lens before using the OA apparatus wear glasses or lens after using OA apparatus emerged as 28.3% of whole. As for the existence or non-existence of use career of OA apparatus, the case under 3 years was highest as 52. 7%. As for the skillfulnness degree about the use of apparatus for office automation, most of them are skillful with the fact that 'common' was 44.4%, 'skill' was 42.5%, and 'unskillful' was 13.1% As for the use average hours of the apparatus for office automation per 1 day, the distribution showed that the case under 3-6 hours was 33.1%, the case under 6-9 hours was 28.1%, the case under 3 hours was 30.6%, and the case over 9 hours was 8.1% Main OA business and the use hours for 1 day showed in the order of keeping and retrieval, business of information transmission(162min), business of information transmission(79.3 min), business of document framing(55.5 min), and business of duplication and printing(25.4min). as for the rest during the use of apparatus for affice automation, that I take rest occasion demands the major portion, but that I take after completing the work emerged as 33.8%. Though the subiness gets to be convenient by the use of the apparatus for of office automation, respondents who showed the dissatisfaction about the present OA business emergd high as 78.1%. The work circumstances of each office was good with the fact that the temperature of office was 21.8, noise was average 42.7db, and the illumination was average 364.4 lx, in the light of ANSi/HFS 100 Standard. 3. Sight syptom, musculoskeletal symptom, skin and other symptoms showed the significant difference according to the extent of skillfulness of the apparatus for office automation. All the symptoms exept skin symptom showed the difference according to the use hours of the apparatus for office automation. All the question items exept the sytoms of digestive organs and the rest hours during the apparatus for office automation showed the signicant difference. The question item which showed the signicant difference from the satisfaction degree of present OA business showed the significant difference from all the question item classified into 6 groups. But, age and school career didn't significant difference from the complaint of any self-consciousness symptoms.

    . In conclusion, the self-consciousness symptoms of the subjects to use OA apparatus appeared differently, according to sex distiction, skillfull degree of OA apparatus, use hours of OA apparatus, the rest hours during th use of OA apparatus, and the satiafaction degree of persent business. Therefore, it is necessary that the nurse in the inuctry field must recognize to receive the education about the human technological physical condition which is most proper for te use of OA apparatus and about the proper rest method until they get accustomed to the use of OA apparatus. In addition, the simple exercise relax the tention of muscle due to the repetitive simple movement, and the education for the protection of eyesight are necessary.

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  • Urinary Tract Infection Following Voiding Cystourethrography (배뇨 방광 요도 조영술 시행 후 발생하는 요로 감염에 대한 고찰)

    • Ryu, Jung-Min;Ahn, Yo-Han;Lee, So-Hee;Choi, Hyun-Jin;Lee, Beom-Hee;Kang, Hee-Gyung;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
      • Childhood Kidney Diseases
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      • v.12 no.2
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      • pp.194-201
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      • 2008
    • Purpose : Voiding cystourethrography(VCUG) is required to detect vesicoureteral reflux(VUR), which may manifest as urinary tract infection(UTI) in children. It is well known that VCUG can cause UTI(post-VCUG UTI). In this study, risk factors for post-VCUG UTI and the preventive effect of antibiotics against this complication of VCUG were explored. Methods : Medical records of 284 patients who underwent VCUG at our hospital in 2007 were reviewed retrospectively. The incidence of post-VCUG UTI and risk factors for post-VCUG UTI, and the impact of antibiotic use on prevention of post-VCUG UTI were evaluated. According to antibiotics usage, we divided the enrolled patients into 4 groups of noantibiotics group, prophylactic antibiotics group(prophylactic antibiotics having been used before), antibiotics-for-VCUG group(antibiotics added for VCUG) and antibiotics-for-treatment group(treatment dose of antibiotics). Results : Seven of 284 children(2.5%) developed UTI after they underwent VCUG. Highgrade(grade$\geq$III) VUR was the only statistically significant risk factor(odds ratio[OR] 6.266, P=0.026) for post-VCUG UTI, while sex, age, and other anomalies of urinary system were not significant. Five post-VCUG UTI cases belonged to prophylactic antibiotics group. Antibiotics use (three groups using antibiotics vs. no-antibiotics group) or addition of antibiotics for VCUG (antibiotics-for-VCUG vs. other groups) did not have any effect on prevention of post-VCUG UTI. Conclusion : The risk factor for post-VCUG UTI was high-grade VUR. Antibiotics use did not prevent post-VCUG UTI in this study.

    A Study on Farmer's Syndrome and Its Risk Factors of Vinyl House Worker and Farmer in a Rural Area (일부 농촌지역 비닐하우스 재배자들의 농부증 실태와 관련요인)

    • Lee, In-Bae;Lee, Yeon-Kyeong;Chang, Sung-Sil;Lee, Sok-Goo;Cho, Young-Che;Lee, Dong-Bae;Lee, Tae-Yong
      • Journal of agricultural medicine and community health
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      • v.24 no.1
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      • pp.13-33
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      • 1999
    • The aim of this study was to investigate fatigue scores, physical complaints, farmer's syndrome and to find out its risk factors among farmers. The questionnaire survey was conducted to 177 vinyl house workers and 213 farmers who lived in Chongyang gun of Chungnam province from February 24 to March 15, 1998. The obtained main results were followings; 1. The fatigue scores were not significantly different between vinyl house workers and farmers. The fatigue scores were higher in female group, lower education group, shorter sleep hours group(under 8 hours), nonsmoker, nondrinker group than otherwise groups. There was not statistically significant difference between the mean fatigue scores and age, eating habit and body mass index. Duration of farming years in vinyl house and farming area and number of farming workers in farmers family showed a slight relationship with the fatigue score. 2. Health scores were not different between vinyl house workers and farmers. The health states was poorer in female group, lower education group, shorter sleep hours group(under 8 hours), nonsmoker group, and nondrinker group than otherwise groups by health scores. Health scores were not related with age, eating habit and body mass index. 3. The proportion of farmer's syndrome was 49.1% in vinyl house workers and 52.1% in farmers. That was higher in female than in male and the higher proportion was found in the lower education group of vinyl house workers and farmers. The proportion of farmer's syndrome was higher in the group of smoker, alcohol drinkers and over or under weight in vinyl house workers, but did not differ in those of farmers. 4. By multiple logistic regression, sex and sleep hours were risk factors affecting to farmer's syndrome. Odds ration for female group was 2.53 (reference group was male) and that for over 8 sleep hours group was 0.74 (reference group was under 8 sleep hours group). 5. The chief complaints by CMI were "I am difficult to work due to aching the back and the limbs", "I feel prickle pain in the limbs", "I sometimes have a twinge in the limbs", "I am not quite well as having a pain in the limbs", "I feel weaker grasping power than before" in both of vinyl house workers and farmers. Vinyl house workers more frequently pointed out skin darkening, skin disease and hemorrhoids than farmers. 6. According to correspondence analysis, skin disease of vinyl house workers was related to vinyl house farmers and digestive and general symptom was associated with male and endocrinological and muscular symptom was associated with female in vinyl house workers. And it revealed that farmer's syndrome was highly related with female and farmers relatively. By the above results, the fatigue scores, perceive health and farmer's syndrome did not much differ in two groups, but aged female farmers should be considered as female farmers represented higher fatigue score, farmers syndrome and poorer perceive health than male farmers in addition to farmer's syndrome was increased with ageing process. Also feeble but distinguished symptoms which might be due to working environment were observed especially in vinyl house workers and that should be considered and investigated continuously.

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    Comparative Study on the Regimens with Pyrazinamide or Ofloxacin in the retreatment of pulmonary tuberculosis (폐결핵 재치료에서 Pyrazinamide 복합처방과 Ofloxacin 복합처방의 효과에 관한 비교 연구)

    • Choi, In Hwan;Park, Seung Kyu;Kim, Kyeong Ho;Kim, Jin Ho;Kim, Cheon Tae;Song, Sun Dae
      • Tuberculosis and Respiratory Diseases
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      • v.43 no.6
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      • pp.871-881
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      • 1996
    • Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-tenn use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4 - fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd ami-tuberculosis regimens for the first lime. We separated the patients by two groups.(Group I : OFX+ PTA + CS+PAS + Injection, Group II: PZA + PTA+ CS + PAS + Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by $\chi$2-test and T-test. Results : 1. The age distribution was most frequent in fourth decade(29.2% in Group I, 37.1% in Group II) and the mean age was 43.9 year in Group I, and 39.0 year in Group II, but had no significant difference between two groups. The sex distribution was more frequent in the males(68.8% in Group I, 85.7% in Group II), but had no significant difference. 2. Family history was 29.2% in Group I, 28.6% in Group II, but had no significant difference. 3. In the respect of extent of disease, far-advanced stare was 60.4% in Group I, 74.3% in Group II, but had no significant difference. 4. The side effects for drugs showed in 58.3% in Group I and 65.7% in Group II, and the gastrointestinal trouble showed 25.0% in Group and arthralgia 34.3% in Group II predominantly respectively and had the significant difference(p<0.05). 5. The negative conversion rate on sputum AFB smear was 87.5% in Group I and 80.0% in Group II, but had no significant difference. But the negative conversion rate on sputum AFB culture was 83.3% in Group I and 57.1 % in Group II and had the significant difference(p<0.05). 6. The success rate of treatment was 87.5 % in Group I and 83.3 % in Group II but had no significant difference. Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and can be use effectively substituting for PZA.

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    Prediction Formulas of Pulmonary Function Parameters Derived from the Forced Expiratory Spirogram for Healthy Nonsmoking and Smoking Adults and Effect of Smoking on Pulmonary Function Parameters (비흡연 및 흡연 성년 한국인에서의 노력성호기곡선을 이용한 폐활량측정법 검사지표들의 추정상치 및 이에 대한 흡연의 효과)

    • Cho, Won-Kyoung;Kim, Eun-Ok;Myung, Seung-Jae;Kwak, Seung-Min;Koh, Youn-Suck;Kim, Woo-Sung;Lee, Moo-Song;Kim, Won-Dong
      • Tuberculosis and Respiratory Diseases
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      • v.41 no.5
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      • pp.521-530
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      • 1994
    • Background : The past studies on prediction formulas of pulmonary function parameters in healthy nonsmoking Korean adults have been performed in relatively small number of subjects and the reported results were restricted on a few parameters. Also there was no systematic investigation into the effect of smoking on pulmonary function parameters in smokers who have no respiratory symptoms. Therefore we attempted to establish prediction formulas of pulmonary function parameters and examined the effect of smoking on pulmonary function parameters. Methods We analyzed the result of parameters derived from the forced expiratory spirogram in 1,067 nonsmoking subjects from June in 1990 to December in 1991. They consisted of 306 males and 761 females and had neither respitatory symptoms nor history of respiratory disease. We derived prediction formulas by multiple linear regression method from their age, heights, and weights in each sex. To examine the effect of smoking on pulmonary function parameters, we classified 383 smoking men into three groups according to the past amount of smoking as follows : i.e. group of smokers who have smoked below 10 pack-years, 10-20 pack-years and above 20 pack-years. Regarding each group of past smoking as an independent dummy variable, we analyzed pulmonary function parameters including nonsmoking men as a baseline by multiple linear regression. We evaluated the smoking effect on pulmonary function parameters according to estimated p-value. Result : 1) Prediction formulas for pulmonary function parameters in each sex were derived. 2) The past smoking less than 10 pack-years does not give any effect on pulmonary function parameters. The past smoking of 10~20 pack-years showed significant negative correlation with $FEV_1$/FVC and FEF 25~75%, and the smoking above 20 pack years showed negative correlation with $FEV_1$ and $FEV_1$/FVC. Conclusion : We have got prediction formulas of pulmonary function parameters which is driven from forced expiratory spirogram in nonsmoking Korean adults by multiple linear regression from age, heights and weights of subjects. The past smoking more than 10 pack-years showed negative correlation with some pulmonary function parameters of airflow obstruction.

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    The Prognostic Value of the First Day and Daily Updated Scores of the APACHE III System in Sepsis (패혈증환자에서 APACHE III Scoring System의 예후적 가치)

    • Lim, Chae-Man;Lee, Jae-Kyun;Lee, Sung-Soon;Koh, Youn-Suck;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Park, Pyung-Hwan;Choi, Jong-Moo
      • Tuberculosis and Respiratory Diseases
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      • v.42 no.6
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      • pp.871-877
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      • 1995
    • Background: The index which could predict the prognosis of critically ill patients is needed to find out high risk patients and to individualize their treatment. The APACHE III scoring system was established in 1991, but there has been only a few studies concerning its prognostic value. We wanted to know whether the APACHE III scores have prognostic value in discriminating survivors from nonsurvivors in sepsis. Methods: In 48 patients meeting the Bones criteria for sepsis, we retrospectively surveyed the day 1(D1), day 2(D2) and day 3(D3) scores of patients who were admitted to intensive care unit. The scores of the sepsis survivors and nonsurvivors were compared in respect to the D1 score, and also in respect to the changes of the updated D2 and D3 scores. Results: 1) Of the 48 sepsis patients, 21(43.5%) survived and 27(56.5%) died. The nonsurvivors were older($62.7{\pm}12.6$ vs $51.1{\pm}18.1$ yrs), presented with lower mean arterial pressure($56.9{\pm}26.2$ vs $67.7{\pm}14.2\;mmHg$) and showed greater number of multisystem organ failure($1.2{\pm}0.8$ vs $0.2{\pm}0.4$) than the survivors(p<0.05, respectively). There were no significant differences in sex and initial body temperature between the two groups. 2) The D1 score was lower in the survivors (n=21) than in the nonsurvivors ($44.1{\pm}14.6$, $78.5{\pm}18.6$, p=0.0001). The D2 and D3 scores significantly decreased in the survivors (D1 vs D2, $44.1{\pm}14.6$ : $37.9{\pm}15.0$, p=0.035; D2 vs D3, $37.9{\pm}15.0$ : $30.1{\pm}9.3$, p=0.0001) but showed a tendency to increase in the nonsurvivors (D1 vs D2 (n=21), $78.5{\pm}18.6$ : $81.3{\pm}23.0$, p=0.1337; D2 vs D3 (n=11), $68.2{\pm}19.3$ : $75.3{\pm}18.8$, p=0.0078). 3) The D1 scores of 12 survivors and 6 nonsurvivors were in the same range of 42~67 (mean D1 score, $53.8{\pm}10.0$ in the survivors, $55.3{\pm}10.3$ in the nonsurvivors). The age, sex, initial body temperature, and mean arterial pressure were not different between the two groups. In this group, however, D2 and D3 was significantly decreased in the survivors(D1 vs D2, $53.3{\pm}10.0$ : $43.6{\pm}16.4$, p=0.0278; D2 vs D3, $43.6{\pm}16.4$ : $31.2{\pm}10.3$, p=0.0005), but showed a tendency to increase in the nonsurvivors(D1 vs D2 (n=6), $55.3{\pm}10.3:66.7{\pm}13.9$, p=0.1562; D2 vs D3 (n=4), $64.0{\pm}16.4:74.3{\pm}18.6$, p=0.1250). Among the individual items of the first day APACHE III score, only the score of respiratory rate was capable of discriminating the nonsurvivors from the survivors ($5.5{\pm}2.9$ vs $1.9{\pm}3.7$, p=0.046) in this group. Conclusion: In sepsis, nonsurvivors had higher first day APACHE III score and their updated scores on the following days failed to decline but showed a tendency to increase. Survivors, on the other hand, had lower first day score and showed decline in the updated APACHE scores. These results suggest that the first day and daily updated APACHE III scores are useful in predicting the outcome and assessing the response to management in patients with sepsis.

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    A Study and Investigation for the Attitude about Smoking of Boys' and Girls' High School in Seoul (서울시내 남녀고교생의 흡연에 관한 태도 조사연구)

    • Sim Young Ae
      • Journal of Korean Public Health Nursing
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      • v.3 no.1
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      • pp.74-100
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      • 1989
    • Inspite of the lots of studies on the harmfulness of cigarette smoking to the body published by many researchers since 1950, cigarette smoking people are increasing in number especially, cigarette smoking by young and women causes a serious problem. Examining the physiological motives of youth shows that, impulse which the youth want to immitate the adults, alluring curiousity, and defiant physiology of escaping from the norm of traditional groups which has been banned are cooperated well compoundly. As the period of the youth is the one which they accumulate knowledge and charactor by learning as well as the period of growth mentally, and physically they should be rightly educated about smoking before they addicted to smoking and it is desirable for us to make the youth to understand how harmfully the smoking is to effect to their growth and mental soundness simply not as a social norm which they should not smoke. The main motive of this study on the attitude of smoking by the youth is to give basic materials related on this field. For this study, 647 questionnaires were used as studying material which were able to analyze among 720 questionnaires of 2 classes of each grade of 3 high schools among the high schools of boys, girls and co-educated in Seoul from Oct. 21, 1988 through Oct. 26, 1988. Study Instrument are graded in Likert's 5 point from 40 questions which are 20 questions m affirmations and 20 questions in negations after analyzing the factors on 60 simple sentence questions which the students showed in preliminary studies. And these are systemized to be measured from 1 point which means they think smoking IS very bad to 5points which means they think smoking is really good. In these collected materials, technical statistics of frequency. percentage, average, standard deviation are used for general character and smoking attitude, $X^2-test$ for examinning Independant variables of physical. emotional, ethical and other areas pearson's coefficient of correlation for related direction and degree" and step­regression analysis for the degree of relative contribution of all variables which effect smoking attitude. The results of this study are as follows; 1. The smoking attitude of high school boys and girls showed average of 1.78 in physical area, 2.63 in emotional area, 2.61 in ethical area, 2.29 in other area respectively in a negative attitude generally also the negative attitude are expressed most strongly in physical area. I've can also say by this results that smoking is harmful to their health and further more it can be judged that this proves the youth in the period of preparation be adults have a strong curiousity in the emotional, ethical and other areas. 2. The most influential variables in each field as related factors effecting smoking attitude of the student can be explained from 13.2 in physical area the lowest experienced variables to 25.2 in emotional area the highest of degree of smoking experience. The fact that the more the smoking experienced students are increasing in number the higher tendency which accept the' smoking tells as the importance of health education about the population of latest student's smoking as important variables shown equally in each area. Those of grade, age, numbers of smoking people in house are showed meaningful in pure interrelation. Those related to the acceptance of teacher's smoking, sex, mothors education are shown meaningful in opposite interrelations. This means that the' increasing number' of smoking people in grade age, the number of smoker in family have a affirmative attitude. And people who are not interested in teacher's smoking wants to quit it, and whose mother's education is higher have a negative attitude. 3. The most negatively answered questions of the smoking attitude In physical, emotional, ethical and other areas are as belows; Firstly too much smoking is harmful to our health is 1.12 point. Secondly smoking have a ill-effect on pregnancy and embryo is 1.13 point. Thirdly smoking is harmful· to our health is 1.27 point. Fourthly smoking in crowed area with the people such as In a bus or subway should be prohibited is 1.27point. Fifthly smoking can ruin lungs is 1.31 point. And the most affirmatively answered questions are also as below; Firstly we showed smoke depending on time and place is 3.96 points. Secondly smoking is just habit is 3.83 points. Thirdly smoking people seem to be unable and deplorable is 3.69 point. Fourthly smoking should be prohibited by law is 3.56 points. Fifthly high school student's smoking is immitation of adults is 3.52 points.

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