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S-372 Characteristics of the patients with healthcare-associated pneumonia
( Bonil Park ),( Jaehwa Choi ),( Bumjoon Kim ),( Keun Bae Jeong ),( Seok Jeong Lee ),( Sang-ha Kim ),( Won-yeon Lee ),( Suk Joong Yong ),( Myoung Kyu Lee ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Introduction: To evaluate clinical and microbiological features in patients with healthcare-associated pneumonia (HCAP) admitted to the intensive care unit (ICU). Methods: Demographic, clinical and microbiological data were retrospectively reviewed from patients with HCAP admitted to a respiratory ICU. Patients were categorized into four HCAP groups: (A) residence in a long-term nursing-home setting or healthcare home; (B) discharge from hospital in the preceding 90 days; (C) elderly or physically disabled patients who stay at home but require healthcare; (D) continuously receiving outpatient endovascular therapy including chronic dialysis, anticancer drugs, and immunosuppressants. Pneumonia severity index (PSI), CURB-65, duration of ICU stay and 30-day mortality were evaluated. Results: Out of 428 patients reviewed (male, 67.1%; mean age, 71.2±11.9 years), 30-day mortality was 25.5%, and duration of ICU stay was 13.8±13.3days. Mortality rate was not significantly different between the four HCAP groups; duration of ICU stay was significantly longer in groups C and D. PSI score, serum HCO3- level, duration of ICU stay, extended spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae and multi-drug resistant (MDR) Acinetobacter baumannii were significantly associated with 30-day mortality. Conclusions: ESBL-producing K. pneumoniae, MDR A. baumannii and PSI score should be considered in ICU patients with HCAP.
( Jaehwa Choi ),( Bonil Park ),( Bumjoon Kim ),( Keun Bae Jeong ),( Seok Jeong Lee ),( Sang-ha Kim ),( Won-yeon Lee ),( Suk Joong Yong ),( Myoung Kyu Lee ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Introduction: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are important causes of hospital admission and mortality. We investigated the clinical features of hospitalized patients with severe AECOPD and evaluated prognostic factors associated the readmission or mortality due to re-exacerbation of COPD within 6 months. Methods: The prospective study was enrolled 314 patients who hospitalized with severe AECOPD. And we collected demographic, clinical and laboratory findings at admission. Lung function was evaluated using the COPD assessment test (CAT) questionnaire, the modified Medical Research Council (mMRC) dyspnea scale, and spirometry in the stable state. Results: The mean age was 72.2±9.4 years (76.4% of male), and the rate of readmission within 6 months was 45.2% and mortality rate was 16.6%. When multivariate analysis was performed by using the significant variables, age (p<0.001), CAT score (p<0.001), initial PaO2 (p=0.026), hemoglobin (p=0.009), albumin (p=0.005) and CRP at discharge (p<0.001) were significantly associated with mortality. And also CAT score (p<0.001) and CRP at discharge (p=0.004) were significantly associated with readmission. In receiver operating characteristic curves, CRP at discharge than CAT score showed a good accuracy to predict the mortality. But CAT score showed good accuracy to predict readmission due to severe AECOPD. Conclusions: CRP at discharge as well as CAT score was significantly associated with both mortality and readmission due to AECOPD.
새만금간척지에서 점적관수량이 토양염농도와 녹색꽃양배추의 생육에 미치는 영향
배희수(Bae Huisu),황재복(Hwang Jaebok),김학신(Kim Haksin),구본일(Gu Bonil),최인배(Choi Inbae),박태선(Park Taeseon),박홍규(Park Hongkyu),이수환(Lee Suhwan),오양열(Oh Yangyeol),이상훈(Lee Sanghun),이건휘(Lee Geonhwi) (사)한국생물환경조절학회 2015 생물환경조절학회지 Vol.24 No.4
본 연구는 새만금 간척지에서 비닐하우스 작물 재배 가능성 검토를 위해 녹색꽃양배추를 대상으로 일일 관수량을 달리하여 관수량에 따른 토양 염농도 및 생육특성 등을 조사하여 관수량에 의한 재염화 억제효과를 알아보고자 수행하였다. 수확기의 표토의 평균 토양 EC 는 1.5 및 3.0mm·day<SUP>-1</SUP> 처리구에서 각각 10.9 및 11.5dS·m<SUP>-1</SUP>였으며 6.0mm·day<SUP>-1</SUP> 처리구에서 5.1dS·m<SUP>-1</SUP>로 1.5 및 3.0mm·day<SUP>-1</SUP> 처리구보다 52~56% 낮게 나타나 점적관수량에 따른 제염효과를 확인할 수 있었다. 화뢰의 무게는 6.0mm·day<SUP>-1</SUP> 처리구에서 주당 371.3g으로 1.5 및 3.0mm·day<SUP>-1</SUP> 처리구의 60.9g 및 129.1g보다 높은 값을 나타냈다. 50%의 수량감소를 보이는 토양 EC는 7.6dS·m<SUP>-1</SUP>였으며 점적관수에 의한 토양 제염효과는 6.0mm·day<SUP>-1</SUP> 처리에서 30~40cm 깊이까지 나타났다. 따라서 새만금간척지에서 녹색꽃양배추 재배시 점적관수에 의한 토양 재염화 억제를 위해서는 6.0mm·day<SUP>-1</SUP> 수준의 관수량으로 총 422mm의 물량이 필요할 것으로 예측된다. 그러나 염류의 이동은 토양 이화학적 특성 및 계절적 요인 등 여러 가지 환경요인에 영향을 받으므로 간척지 비닐하우스에서 점적관수에 따른 염류의 이동특성에 관한 추가적인 연구가 필요할 것으로 판단된다. The objective of this study was to investigate the effect of drip irrigation level on soil salinity and growth of broccoli (Brassica oleracea L. var. italica) at the ‘Saemangeum Reclaimed Tidal Land’ from April to June, 2015. Drip irrigation was conducted at 1.5, 3.0 and 6.0mm·day<SUP>-1</SUP> level for reduction of resalinization in the plastic vinyl house using 10cm spacing drip irrigation tape. At harvesting stage, the average EC of surface soil was 10.9dS·m<SUP>-1</SUP> for 1.5mm·day<SUP>-1</SUP>, 11.5dS·m<SUP>-1</SUP> for 3.0mm·day<SUP>-1</SUP> and 5.1dS·m<SUP>-1</SUP> for 6.0mm·day<SUP>-1</SUP> and was significantly reduced by 52~56% in 6.0mm·day<SUP>-1</SUP> treated plot compared to those in 1.5 and 3.0mm·day<SUP>-1</SUP> plots. The fresh bud weights of 1.5, 3.0 and 6.0mm·day<SUP>-1</SUP> treatment plots were 60.9, 129.1 and 371.3g·plant<SUP>-1</SUP>, respectively. The estimated soil EC for 50% yield reduction was 7.6dS·m<SUP>-1</SUP> and the desalinization depth by drip irrigation was 30~40cm in soil profile. The total amount of drip irrigation water was estimated to be 422mm and the daily drip irrigation level was 6.0mm·day<SUP>-1</SUP> for the prevention of resalinization during the broccoli growing period at the ‘Saemangeum Reclaimed Tidal Land’. Our results suggested that drip irrigation shows effectiveness on the lowering the soil salinity according to the drip irrigation quantity but it needs more research on this study because dynamics of salts in soil can vary with many factors such as soil physico-chemical properties and seasonal climate.
( Seong Hee Kang ),( Jhii-hyun Ahn ),( Moon Young Kim ),( Seul Ki Han ),( Bonil Park ),( Young Ju Kim ),( Soon Koo Baik ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: Hepatic venous pressure gradient (HVPG) measurement is a validated method, which accurately evaluates changes in portal hypertension (PH). Magnetic resonance elastography (MRE) is a well-established method for liver fibrosis staging. We investigated the correlation between MRE-assessed stiffness of the liver and spleen and HVPG values. Furthermore, we evaluated whether MRE values reflected changes in PH after the administration of ß-blockers. Methods: From January 2018 to September 2019, we enrolled 37 consecutive patients with cirrhosis requiring prophylactic treatment of esophageal varices according to the Baveno VI criteria were prospectively included. At enrollment, patients were initiated on carvedilol starting at a dose of 6.25 mg/day, which was up-titrated to 12.5 mg/day. Patients underwent HVPG measurement and multifrequency MRE at baseline and 6 weeks. Results: The median HVPG and MELD score of the patients was 15.0 mmHg (Interquartile range [IQR], 11.5-20.5) and 11.4 (IQR, 8.5-13.9), respectively. Median baseline values of MRE-assessed liver and spleen stiffness were 5.92 kPa (IQR, 4.89-7.10) and 8.38 kPa (IQR, 7.38-9.43), respectively. Multiple linear regression analysis revealed a significant correlation between HVPG and MRE-assessed liver stiffness (γ=0.485, P=0.004), but not MRE-assessed spleen stiffness (γ=-0.065, P=0.708). Median 6-week changes in MRE-assessed liver stiffness (Δliver), spleen stiffness (Δspleen) and HVPG (ΔHVPG) were -0.4 kPa, -0.13 kPa, and -1.5 mmHg, respectively. Overall, neither MRE-assessed Δliver (γ=0.311, P=0.170) nor MRE-assessed Δspleen (γ=-0.135, P=0.559) was correlated with ΔHVPG. However, using the categorized stage of HVPG, MRE-assessed Δliver significantly correlated with ΔHVPG in patients with low-HVPG ≤16 mmHg (γ=0.575, P=0.040), though not in patients with high-HVPG >16 mmHg (γ=-0.048, P=0.909). Conclusions: MR parameters related to liver stiffness provide excellent accuracy for diagnosing PH, and reflect changes in HVPG following administration of ß blockers for less severe PH.