• Tuberculosis and Respiratory Diseases
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• 제83권1호
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• pp.81-88
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• 2020

Background: Use of appropriate antibiotics for the treatment of pneumonia is integral in patients admitted to intensive care units (ICUs). Although it is recommended that empirical treatment regimens should be based on the local distribution of pathogens in patients with suspected hospital-acquired pneumonia, few studies observe patients admitted to ICUs with nursing home-acquired pneumonia (NHAP). We found factors associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the emergency room (ER). Methods: We performed a retrospective cohort study of 83 pneumonia patients with confirmed causative bacteria admitted to ICUs via ER March 2015-May 2017. We compared clinical parameters, between patients who received appropriate or inappropriate antibiotics using the Mann-Whitney U, Pearson's chi-square, and Fisher's exact tests. We investigated independent factors associated with inappropriate antibiotic use in patients using multivariate logistic regression. Results: Among 83 patients, 30 patients (36.1%) received inappropriate antibiotics. NHAP patients were more frequently treated with inappropriate antibiotics than with appropriate antibiotics (47.2% vs. 96.7%, p<0.001). Methicillin-resistant Staphylococcus aureus was more frequently isolated from individuals in the inappropriate antibiotics-treated group than in the appropriate antibiotics-treated group (7.5% vs. 70.0%, p<0.001). In multivariate analysis, NHAP was independently associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via ER. Conclusion: NHAP is a risk factor associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the ER.

• 대한한방내과학회지
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• 제30권2호
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• pp.422-430
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• 2009

Background : Stroke is the second leading cause of death in Korea, following cancer. Stroke consists of ischemic and hemorrhagic stroke, and ischemic stroke can be largely classified as atherothrombotic stroke or embolic stroke. Carotid intima-media thickness (IMT) is an indicator of atherosclerosis used commonly as a screening test for abnormalities of the coronary artery. 24-hour ambulatory ECG is widely used to screen for underlying diseases that causes syncope, palpitation, arrhythmia, etc. Objectives : Since both carotid IMT and 24-hour ambulatory ECG are used to screen for cardiac problems, we endeavored to explore the correlation between carotid IMT and 24-hour ambulatory ECG of stroke patients. Methods : The records of ischemic stroke patients who were admitted to Kyunghee Medical Center Oriental Hospital ward from March 2006 to May 2009 were reviewed. 28 patients who had both carotid Doppler US and 24-hour ambulatory ECG test undertaken during their admission were analyzed. The relationship of abnormal ambulatory results and common carotid artery(CCA) IMT were statistically analyzed using Fisher's exact test and t-test. Results : The mean age of the abnormal ambulatory group was older than the normal group (74${\pm}$ 8.0 vs. 61${\pm}$12.1, p=0.0098). Although insignificant, the abnormal ambulatory group showed much thicker CCA-IMT than normal ambulatory group (2.l7${\pm}$ 1.16 vs. 1.51${\pm}$0.97. p=0.l389). Conclusion: No significant correlation was observed between abnormal ambulatory results and CCA-IMT. However, the difference in CCA-IMT between the two groups was too big to be ignored and further investigation with larger and better controlled trials are warranted.

• Archives of Plastic Surgery
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• 제37권5호
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• pp.531-534
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• 2010

Purpose: Lipobean$^{(R)}$s, widely used in lipodissolving techniques, contain phosphatidylcholine and sodium deoxycholate as its main substances. They have been approved only as medication for liver disease by the FDA. However, they have been used under various clinical settings without exact knowledge of its action mechanism. The authors designed an in vitro study to analyze the effects of different concentrations of phosphatidylcholine and sodium deoxycholate on adipocytes and other types of cells. Methods: Human adipose-derived stem cell were cultured and induced to differentiate into adipocytes. Fibroblasts extracted from human inferior turbinate tissue, and MC3T3-E1 osteoblast lines were cultured. Phosphatidylcholine solution dissolved with ethanol was applied to the culture medium at differing concentrations (1, 4, 7, 10 mg/mL). The sodium deoxycholate solution dissolved in DMSO applied to the medium at differing concentrations (0.07, 0.1. 0.4. 0.7 mg/mL). Cells were dispersed at a concentration of $5{\times}10^3$ cells/well in 24 well plates, and surviving cells were calculated 1 day after the application using a CCK-8 kit. Results: The number of surviving cells of adipocytes, fibroblasts and osteoblasts decreased as the concentration of sodium deoxycholate increased. However, all types of cells that had been processed in a phosphatidylcholine showed a cell survival rate of over 70% at all concentrations. Conclusion: This study shows that sodium deoxycholate is the more major factor in destroying adipocytes, and it is also toxic to the other cells. Therefore, we conclude that care must be taken when using Lipobean$^{(R)}$s as a method of reducing adipose tissue, for its toxicity may destroy other nontarget cells existing in the subcutaneous tissue layer.

• 응용통계연구
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• 제21권1호
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• pp.19-33
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• 2008

연속 형질(quantitative trait)에 영향을 미치는 유전자를 알아내기 위해 형제 쌍의 자료를 수집하여, 주로 이용되는 Haseman과 Elston (1972)의 최소제곱 회귀검정법으로 분석하는데 이는 단일 형질에 대한 분석법이다. 현실적으로 여러 형질들이 복잡하게 단일유전자 좌위(single locus)와 연관되어 있어 함께 수집하게 되는 경우에는, 이러한 연관된 여러 형질을 동시에 분석하는 유전연관성 검정법(linkage test)이 절실히 필요한 실정이다. Amos 등 (1990)은 주성분(principal component) 선형모형을 이용하여 Haseman과 Elston (1972)방법을 둘 이상의 형질의 다변량 분석법으로 확장시켰다. 그러나 이 검정방법은 통계량의 분포를 알 수 없기에 아직 제 1종 오류가 제대로 통제되지 못하는 문제를 가지고 있다. 본 논문에서는 이러한 다변량 형질 자료의 연관성검정에 있어 단일변량에 대한 비모수 추세검정법을 다변량 자료에 대한 분석법으로 확장시킨 통계량을 사용할 것을 제안한다. Amos 등 (1990)이 제안한 방법과 다변량 추세검정 통계량을 모의실험으로 생성한 연속형 형질자료에 적용하였을 때, 다변량 추세검정 통계량은 Amos 등 (1990) 방법에서의 여러 문제점이 발생되지 않을 뿐만 아니라 모의실험에서 제 1종 오류가 정해진 유의수준에 가까운 것을 확인하였고, 검정적이 더 높음을 볼 수 있었다.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.89-94
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• 2011

Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.

• Journal of Nutrition and Health
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• 제10권2호
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• pp.18-26
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• 1977

Among animals, the rabbit is known to be affected most sensitively by dietary changes and to be most susceptible to atherosclerosis. The exact reason is still unknown as to whether the primary cause is intrinsic (tissue itself) or extrinsic such as a blood factor which could be influenced by various dietary means. It is of utmost importance to check the nutritional quality of rabbit meat before it is accepted and adapted as a daily food item. To evaluate nutritional quality of rabbit meat, studies on various aspects of lipid components were carried out in comparison with other animal meats such as beef, pork and chicken also included in the study was the question whether the cooking and storage conditions influence the composition of fatty acids and cholesterol level. Some results and findings are listed below: 1. The content of linoleic acid (18 : 2), one of the essential fatty acids, was much higher in rabbit meat compared to the other meats. The Percentages of this Polyunsaturated fatty acids, was much higher in rabbit meat compared to the other meats. The percentages of this polyunsaturated fatty acid in terms of total fatty acids were $37.3{\pm}3.7$, 5.9, 14.5, and 21.9% for rabbit, beef, pork, and chicken respectively. The degree of unsaturation was high not only in meat but also in liver and adipose tissue of rabbit. The values of iodine number, the indication of degree of unsaturation, were known to be $102{\sim}107$, $32{\sim}47$, $46{\sim}67$, and $55{\sim}77$ for rabbit, beef, pork, and chicken respectively. Such a high proportion of this polyunsaturated fatty acid contained in rabbit meat could be harmful due to their Peroxidation effect. 2. A small amount of lower (short chain) fatty acids was isolated from rabbit tussues, which were not observed in other animal's tissues. The significance of this small amount of short chain fatty acids contained in rabbit meat remained an open question. 3. The concentration of total cholesterol in rabbit meat was similar to that of otherr but the content of esterified cholesterol was higher in rabbit meat. This was probably due to the perference of cholesterol to esterify with unsaturated fatty acids. By roasting the percentage of Polyunsaturated fatty acids was decreased while saturated palmitic acid was proportionally increased. 4 The composition of fatty acids were affected more by dry heat than moist heat. More research should be pursued to improve methods of preservation and storage to prevent possible peroxidation and rancidity problems of rabbit meat. In the meantime, the public should be informed to eat fresh rabbit meat and not to store it for a long period of time. This study was supported by the Ministry of Science and Technology in Korea.

• 한국한의학연구원논문집
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• 제13권2호통권20호
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• pp.65-69
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• 2007

Background and Purpose : The purpose of this case-control study was to show the relationship between risk factors(past medical history, BMI, WHR, smoking, drinking), warning signs(dyscinesia, sightless, dysarthria, sensory disorder, numbness, blephalospasm, facial spasm, tension) and the incidence of stroke in korean adults. Methods : 455 stroke patients were enrolled as the case group and 180 non-stroke patients as control group from Oct. 2005 to Feb. 2006. Patients were hospitalized within 2 weeks after the onset of stroke. Obesity were defined as $BMI{\geq}25kg/m2$, $WHR{\geq}0.9$ in male and $WHR{\geq}0.8$ in female. Risk factors and warning signs were obtained from personal interview. The analysis of the data was done by chi-square test. Fisher's exact test and test-sample t-test. Results : The percentage of current smokers(or current drinkers) of case group is higher significantly than that of control group. The past medical history of risk factors were found to be transient ischemic attack(p=0.0698), facial palsy(p=0.4061), hypertension(p<0.0001), hyperlipidemia(p=0.1484), DM(p<0.0001), ischemic heart disease(p=0.0093), migraine(p=0.0014) and hypochondria(p=0.2370). $WHR{\geq}0.9$ in male had a 6.696 (3.711-12.082) odds ratio, $WHR{\geq}0.8$ in female had a 1.567 (0.659-3.726) odds ratio. $BMI{\geq}25kg/m2$ had a 2.017(1.263-3.222). The dyscinesia and sensory disorder of warning signs were found to be statistical difference between case and control group. Conclusions : According to the above results, it was found that smoking, drinking, BMI, WHR, hypertension, DM, ischemic heart disease, migraine affected to the incidence of stroke.

• The Korean Journal of Pain
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• 제13권1호
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• pp.44-48
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• 2000

Background: The continuous epidural analgesia is a popular method in the management of postoperative pain. However, the exact regimen for the optimal analgesia is still in dispute. In this study, we evaluated the effect of an initial loading dose prior to the continuous epidural infusion after a brief surgery, which may have some residual effects of local anesthetics that is used for the intraoperative epidural anesthesia. Methods: Seventy five patients required epidural anesthesia with 15 ml of 2% mepivacaine for the perianal surgery were randomly divided into three groups: Group 1, being the control group (n=25) did not received postoperative epidural pain control. But, group 2 (n=25) and 3 (n=25) received continuous epidural analgesia with local anesthetics and morphine immediately after surgery. In Group 2, the patients received continuous epidural infusion without initial loading dose. In Group 3, the patients received initial loading dose (1% mepivacaine 6 ml and morphine 1 mg) and followed by continuous epidural infusion. We evaluated the number of patients who needed adjuvant analgesics, the pain score, and incidence of side effects for the postoperative 48 hours. Results: At postoperative 12 hours, in group 3, the two variables, the number of patients who needed analgesics and the pain score showed a statistical significance with low scores compared with group 1 and 2. At postoperative 24 and 48 hours, the two variables indicated above did not show any differences in group 2 and 3. The incidence of side effects is not different among the three groups. Conclusions: The loading dose prior to continuous epidural infusion is necessary after a brief surgery which may have some residual effects of local anesthetics that is used for the intraoperative epidural anesthesia.

• 한국환경보건학회지
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• 제44권5호
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• pp.460-467
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• 2018

Objectives: The objectives of this study are to estimate the inhalation exposure level of benzene for workers using Tier 1 exposure models ECETOC TRA (European Center for Ecotoxicology and Toxicology of Chemicals Target Risk Assessment) and Stoffenmanager, and to investigate their reliability for exposure assessment in K-REACH. Methods: Two exposure scenarios, 'manufacture of benzene' and 'use as solvents,' were developed for assessment of workers' exposure to benzene. The Process Category (PROC) for ECETOC TRA was collected from the European Chemical Agency (ECHA) registration dossier, and the Activity for Stoffenmanager was converted from PROC using translation of exposure models (TREXMO). The information related to exposure, such as working duration, Respiratory Protective Equipment (RPE), Local Exhaust Ventilation (LEV), and Risk Management Measure (RMM) were classified into high, medium, and low exposure conditions. The risk was determined by the ratio of the estimated exposure and occupational exposure limits of benzene. Results: Under high exposure conditions, the worker exposure level calculated from all PROCs and Activities exceeded the risk level, with the exception of PROC 1 and Activity 1. In the medium exposure condition, PROC 8a, 8b, and 9 and Activity 3, 7, and 8 all exceeded the risk, whereas in the low condition, all PROCs and Activities were determined to be safe. As a result, action corresponding with the low exposure condition is required to reduce the risk of exposure among workers in workplaces where benzene is manufactured or used as a solvent. In addition, the predicted exposure levels derived from the exposure models were lower than measured levels. The exposure levels estimated from Stoffenmanager were more conservative than those from ECETOC TRA. Conclusions: This study demonstrates the feasibility of exposure models for exposure assessment through the example of occupational inhalation exposure assessment for benzene. For more active utilization of exposure models in K-REACH, the exact application of collected information and accurate interpretation of obtained results are necessary.

• Journal of Korean Neurosurgical Society
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• 제30권1호
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• pp.47-53
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• 2001

Objective : This study was undertaken to evaluate operative results and prognosis according to preoperative clinical status and histopathological finding of spinal cord tumor. Methods : We analyzed of clinical feature, tumor location, histopathologic finding, operative results and prognosis in 55 patients with spinal cord tumor during last 10 years. Results : 1) The incidence of spinal cord tumors varies with the age of affected patients who are 2 to 75 years of age. Peak incidences were in the 5th & 7th decade of life, and the ratio of male to female was 1.2:1. 2) The most common histopathologic type was neurinoma(41.9%). 3) The tumors were located most frequently in the thoracic area(22 cases, 40.0%) and in the intradural extramedullary space(30 cases, 54.5%). 4) The most common initial clinical feature was pain in 20 cases(36.4%). For neurologic status on admission, 30 cases(54.5%) showed motor disturbance. 5) In radiologic studies, there were abnormal finding in 21 cases from plain X-rays among 37 cases. The entire 20 cases in when myelography was done showed subarachnoid blockade, either complete or incomplete. The magnetic resonance imaging, regard as the most accurate diagnostic method, revealed the exact location of the tumor and the relationship of the tumor with the adjacent anatomical structure. 6) The total removal was possible in 36 cases(65.5%), subtotal removal in 17 cases(30.9%) and biopsy in 2 cases (3.6%). Nineteen cases(90.5%) among 21 cases with preoperative radiculopathy group showed recovery or improvement, where as only 11 cases(36.7%) among 30 cases with preoperative motor weakness group showed recovery or improvement, with statistically significant difference(p<0.01). Pathologically, 26 cases(83.9%) among 31 cases of neurinoma and meningioma showed postoperative recovery or improved, but only 1 case(6.3%) among 16 cases of metastatic tumor, astrocytoma and ependymoma recovered. Postoperative complication noted in 5 cases(9.1%), and were noted postoperative hematoma, pneumonia, pulmonary edema and spinal cord infarction. Conclusion : Preoperative neurologic status and histopathologic finding are considered important factors of Postoperative outcome in patients with spinal cord tumor.