The purpose of this study was to compare the sleep characteristics between the prone and the supine position in healthy newborns. The 48 newborns were observed in the prone position and the supine position respectively on the 2nd day after birth. The data were collected from January to May, 1999. The state of a newborn was classified and categorized to 6 states (deep sleep, light sleep, drowsy, quiet alert, active alert, crying) by Barnard. The movements of eyes, face and extremities, pulse and arterial oxygen were observed and recorded continuously from the start of sleep after feeding until the time of being woken for the next feeding by a trained nurse. The data was analyzed by using paired t-test. The results of this study were as follows; 1. There was no significant difference in the length of sleeping time between the prone and the supine position. 2. There was no significant difference in the length and frequencies of each states(deep sleep, light sleep, drowsy, quiet alert, active alert, crying) between the prone and the supine position. But the frequency of light sleep in the supine position was significantly higher than that of the prone position. 3. There was no significant difference in the numbers of eyes movements between the prone and the supine sleep position. But the amount of facial and extremity movement in the supine position was significantly higher than those in the prone position 4. There was no significant difference in the arterial oxygen content between the prone and the supine sleep position. 5. There was no significant difference in the heart rates between the prone and the supine sleep position. The above results indicated that the newborns in the prone position moved less and slept deeper than those in the supine position, though there was no difference in the length of sleep or arterial oxygen content between the prone and the supine sleep position. But, Nurses and mothers should consider the relationship between the sleep position and SIDS suggested by previous researches. The infant's 'awakening' during sleep is a normal process and rather valuable because it can provide an opportunity to promote a stronger relationship between mother and baby. So, It is suggested that the supine sleep position is better than the prone sleep position for infants.
Extremities ; Heart Rate ; Humans ; Infant ; Infant, Newborn* ; Mothers ; Oxygen ; Parturition ; Prone Position ; Sudden Infant Death ; Supine Position ; Child Health

BACKGROUND: Peak expiratory flow (PEF) provides a simple, quantitative, and reproducible measure of the existence and severity of airflow obstructions. Peak flow meters are designed to monitor the condition asthma patients. There are many reports showing the normal predicted value of PEF in other countries. studies on healthy Korean adults have been performed in a relatively small sample number and a lower limit for the normal value was not reported. therefore, an attempt to provide normal predictive PEF value with a lower limit was made. METHOD: The PEF(Mini-Wright peak Flow Meter) measurements and spirometry were done in 233 men and 631 woman without history of respiratory disease. all subjects were non-smokers with no respiratory symptoms. the normal predictive value and its lower limit were developed by multiple regression analysis. The result was compared with regression equations in other reports. RESULTS: The regression equation for the normal PEF predictive value(L/min) is 25.117+4.587×Age(year)-0.064×Age2+2.931×Height(cm) in men in men(R2=0.25), and 146.942-0.011×Age2+1.795×Height(cm)+0.836×Weight (kg) in women(R2=0.21). The regression equation for the lower limit of this value (L/min) is 25.117+4.587×Age(year)-0.064×Age2+1.936×Height (cm) in men, and 146.942-0.011×Age2+1.232× Height (cm)+0.481×Weight (kg) in women. The residuals were normally distributed. The PEF in Korean males was similar to those reported in British and Japanese subjects. The PEF in Korean females was similar to that in British subjects, But higher than the PEF in Japanese subjects. The lower limit of normal value was 71% of normal predictive PEF value in men and 76% in women. CONCLUSION: The normal predictive PEF value and its lower limit was measured from 233 male and 631 female asymptomatic, lifelong non-smoking participants. The normal predictive value was different from those of other studies on Korean subjects. Therefore, further studies are required.
Adult ; Asian Continental Ancestry Group ; Asthma ; Female ; Humans ; Male ; Reference Values ; Spirometry

No abstract available.
Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

The time course and magnitude of change in mean arterial pressure (MAP) and heart rate (HR) following a single rapid intravenous injection of 1ug/kg and 2ug/kg of sodium nitro prusside(SNP) were determined in 10 anesthetized patients. The results were as follows: 1) MAP began to decrease 15 seconds after both 1ug/kg and 2ug/kg of SNP and was maximal after 90 seconds with return toward control apparent by 3 minutes and complete after 5 to 6 minutes(Fig. 1). 2) The magnitude of decrease in MAP after SNP was dose related whereas onset and duration of blood pressure changes were not influenced by the SNP dose. 3) HR did not change significantly after either dose of SNP. SNP is a potent, rapid acting antihypertensive drug which produces arteriolar vasodilation and prevention of hypertension and is particularly important in patients with decreased myocardial reserve or intracranial pathology.
Arterial Pressure* ; Blood Pressure ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Injections, Intravenous ; Nitroprusside* ; Pathology ; Sodium* ; Vasodilation

BACKGROUND: Blood CD4+ T-lymphocyte (T4) count is a major clinical marker for the diagnosis and management of AIDS, and flow cytometry is considered the gold standard for T4 enumeration. Our aim was to compare the 2-color and 4-color flow cytometric methods for T-cell subset analysis in HIV-infected patients. METHODS: T-cell subsets such as T3, T4, T8, and CD3+CD4-CD8- double negative T cells (DN T) were analyzed from the whole blood of 40 HIV-infected patients by using both 2-color and 4-color methods on a Cytomics FC500 analyzer. Statistical analyses using simple linear regression, paired t-tests, and Bland-Altman plots were performed. RESULTS: The measured T3 (%), T4 (%), T4 (/microL), T8 (%), T8 (/microL), and DN T (%) differed significantly between the 2 methods (P<0.05), whereas the T4/T8 ratio did not. T3 (%), T4 (%), T4 (/microL), T8 (%), T8 (/microL), and T4/T8 measured by the 2 methods showed good correlation, with correlation coefficients above 0.96, whereas DN T (%) did not. The mean differences in T4 (%) and T8 (%) were 0.39% (limit of agreement (LoA), -1.64~2.43) and 1.26% (LoA, -3.37~5.89), respectively. CONCLUSIONS: Although there were statistically significant differences in the T cell subsets measured between the 2 methods, the differences were minor, and the 2 methods showed good correlation. As confirmed in this study, DN T (%) estimated by the 2-color method is lower than the actual value. We suggest that although the 2 methods can be used interchangeably, the 4-color method is recommended for the analysis of some specific subpopulations such as DN T (%).
Biomarkers ; Flow Cytometry ; HIV ; Humans ; Linear Models ; T-Lymphocyte Subsets ; T-Lymphocytes

OBJECTIVES: Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. METHODS: We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. ankle-brachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. RESULTS: The age of diabetic subjects was 68.7+/-8.7 years and the duration of diabetes was 8.9+/-8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. CONCLUSIONS: DM management in low income patients is very poor and requires further work to improve.
Aged ; Blood Glucose ; Blood Pressure ; Body Weights and Measures ; Carotid Arteries/ultrasonography ; Diabetes Mellitus, Type 2/complications/*therapy ; Female ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Hemoglobin A, Glycosylated/analysis ; Humans ; Korea/epidemiology ; Lipids/blood ; Male ; Middle Aged ; Patient Compliance ; *Poverty ; *Rural Population ; Socioeconomic Factors

Recent studies have shown that bilirubin is negatively associated with hemoglobin A1c (HbA1c) in the general population. The association between bilirubin and HbA1c in serum of diabetes patients has not yet been studied. The aim of the present study was to evaluate the association between total bilirubin and HbA1c in Korean patients with type 2 diabetes. A total of 690 of the 1,275 type 2 diabetes patients registered with the public health centers in Seo-gu, Gwangju and Gokseong-gun, Jeollanam-do participated in this study. Following an overnight fast, venous blood and urine samples were collected and analyzed. The mean HbA1c values differed significantly according to total bilirubin (< or = 0.4 mg/dL, 7.6%; 0.5 mg/dL, 7.3%; 0.6-0.7 mg/dL, 7.2%; and > or = 0.8 mg/dL, 7.1%; P for trend = 0.016) after we adjusted for other confounding factors. When the odds ratio (OR) was adjusted for other confounding factors, there was a significant association between total bilirubin and HbA1c (OR, 0.4 [95% confidence interval, 0.2-0.8] for total bilirubin > or = 0.8 mg/dL versus < or = 0.4 mg/dL. In conclusion, total bilirubin concentrations in serum are negatively associated with HbA1c levels after adjustment for sex, age, and other confounding factors in type 2 diabetes patients.
Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Bilirubin/*analysis/blood/urine ; Diabetes Mellitus, Type 2/*blood/diagnosis ; Female ; Hemoglobin A, Glycosylated/*analysis/urine ; Humans ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea ; Risk Factors

BACKGROUND: To compare the predictability of the Framingham Risk Score (FRS), United Kingdom Prospective Diabetes Study (UKPDS) risk engine, and the Systematic Coronary Risk Evaluation (SCORE) for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients. METHODS: Among 1,275 registered type 2 diabetes patients in the health center, 621 subjects with type 2 diabetes participated in the study. Well-trained examiners measured the carotid intima-media thickness (IMT), carotid plaque, and ankle brachial index (ABI). The subject's 10-year risk of coronary heart disease was calculated according to the FRS, UKPDS, and SCORE risk scores. These three risk scores were compared to the areas under the curve (AUC). RESULTS: The odds ratios (ORs) of all risk scores increased as the quartiles increased for plaque, IMT, and ABI. For plaque and IMT, the UKPDS risk score provided the highest OR (95% confidence interval) at 3.82 (2.36, 6.17) and at 6.21 (3.37, 11.45). For ABI, the SCORE risk estimation provided the highest OR at 7.41 (3.20, 17.18). However, no significant difference was detected for plaque, IMT, or ABI (P = 0.839, 0.313, and 0.113, respectively) when the AUCs of the three risk scores were compared. When we graphed the Kernel density distribution of these three risk scores, UKPDS had a higher distribution than FRS and SCORE. CONCLUSION: No significant difference was observed when comparing the predictability of the FRS, UKPDS risk engine, and SCORE risk estimation for carotid atherosclerosis and peripheral arterial disease in Korean type 2 diabetic patients.
Ankle Brachial Index ; Area Under Curve ; Carotid Artery Diseases ; Carotid Artery Thrombosis ; Carotid Intima-Media Thickness ; Coronary Disease ; Diabetes Mellitus, Type 2 ; Great Britain ; Humans ; Odds Ratio ; Peripheral Arterial Disease ; Risk Assessment

PURPOSE: Fentanyl is a synthetic opioid and transdermal therapeutic system (TTS), designed to release the drug into the skin at a constant rate, ranging from 25 to 100 microgram/hr, for up to 3 days. For the control of chronic cancer pain, Durogesic(R) patches (Janssen Co., USA) are now widely used. Recently, the Hana Company in Korea developed a new fentanyl patch, Fentas(R) using a different method. To compare the efficacy, and safety, of the fentanyl patch manufactured in Korea (Hana Pharm. Co. Ltd), with the Durogesic(R) patch, in controlling cancer pain, we performed randomized controlled, open labelled, phase III studies. MATERIALS AND METGODS: From January 2000 to April 2001, 85 patients were enrolled, 69 of whom (42 in D arm and 43 in F arm) completed the study, and were therefore assessable for per protocol (PP) analyses. RESULTS: There were no significant differences between the two groups in baseline characteristics, with the exception of age. The primary end point was to show the therapeutic equivalence of the two patches. In these clinical trials, the confidence interval of difference, between the test drug (Fentas(R)) and the control (Durogesic(R)), was 0.027~ +0.124 by intention to treat (ITT) analysis. Even if the upper confidence interval exceeds + 0.1, the test drug is not superior to the control drug, because the confidence interval includes 0. However, by PP analysis, the confidence interval lies exactly within +/- 0.1. Therefore, we could conclude the two patches are therapeutically equivalent. The second endpoint was the difference of visual analog scale (VAS) between the baseline and the average of three measurements after treatment. The difference in VAS was 50.44+/-10.28 for the F arm, and 44.69+/-11.00 for the D arm. By PP analysis the test drug was superior to the control (p=0.028). The rescue morphine amount was 81.21+/-124.76 for F arm and 66.19+/-115.9 for D arm, and there was no significant difference between the two groups (p=0.6063). The most common adverse effects of both fentanyl patches were nausea or vomiting (55.3%), somnolence (50.0%), constipation (39.5%), gastrointestinal discomfort (57.9%) and headaches (25.0%). In general there was no significant difference in side effects or laboratory data between the two groups. CONCLUSION: These findings suggest that Fentas(R) patches, administered every 3 days, are effective, safe, and well tolerated for the treatment of most patients with cancer pain and is as effective or better than Durogesic(R).
Arm ; Constipation ; Fentanyl ; Headache ; Humans ; Intention ; Korea ; Morphine ; Nausea ; Skin ; Visual Analog Scale ; Vomiting

PURPOSE: The purpose of this study is to examine the prevalence of malnutrition in hospitalized patients aged 18 years old or older at the time of admission in Korea. METHODS: This multi-center, preliminary survey included patients over 18 years old who were admitted on a given day from six hospitals in Korea. Nutritional status was assessed using Subjective Global Assessment tool. Data collected included hospital characteristics, patient characteristics, nutrition screening, and nutrition assessment. RESULTS: Among the 99 patients recruited (47 males, 47.5%), 18 (18.2%) and 2 (2.0%) patients were moderately malnourished and severely malnourished, respectively. The mean age of the malnourished group was older than that of the well-nourished group (49.7+/-17.1 vs. 60.5+/-13.6 years old, P-value=0.010). Patients admitted for medical treatment were more malnourished than those admitted for surgical treatment. CONCLUSION: Results of the multi-center preliminary survey showed 20.2% prevalence of malnutrition on admission. A national survey was piloted and will be followed by full implementation.
Humans ; Inpatients ; Korea ; Male ; Malnutrition ; Mass Screening ; Nutrition Assessment ; Nutritional Status* ; Prevalence