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A Cause Analysis of Missed Fractures in an Emergency Medical Center (응급센터에 내원한 외상환자에서 간과된 골절의 요인 분석)

  • Park, Deuk-Hyun;Lee, Sung-Sil;Kim, Dong-Un;Cho, Hyun-Young;Lee, Young-Geun;Kim, Jun-Su;Jun, Jin;Kim, Young-Sik;Ha, Young-Rock;Sin, Tae-Yong
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.37-43
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    • 2009
  • Purpose: A missed fracture is a very common occurrence in the Emergency Department (ED) and can have serious results because of delays in treatment, resulting in long-term disability. It is also one of the most common causes leading to medical legal issues. We analyzed the causes of missed fractures by using a bone scan which is known to be an effective tool for diagnosing bony lesions. Methods: We reviewed the medical records of trauma patients who underwent a bone scan after being discharged the ED from September 2006 to March 2008. Cases of missed fractures were identified by using electronic medical records to review each diagnosis. Definition of missed fracture was read after bone scan by radiologist. We decided that there was no fracture if we read 'trauma-related lesion' or 'cannot rule out fracture' on a bone scan read by a radiologist. Enrolled patients were analyzed by age, sex, time until bone scan and Injury Severity Score (ISS). Patients were divided into two groups, alert mentality and not-alert mentality, so there were split between a diagnosis group and a missed fracture group. ISS was also used in determining the severity of the patient's injury upon discharge from the ED. Results: A total of 532 patients were enrolled in this study. Of those, 487 patients were in the diagnosis group, and 45 patients (8.4%) were discovered to have had a fracture. Of the 45 missed fracture patients, 34 patients (6.4%) had one-site fractures, 8 patients (1.5%) had two-site fractures, and 3 patients (0.6%) had three-site fractures. The most commonly missed fracture was multiple rib fractures (18 patients, 30.5%), followed by lumbosacral (LS) spine fractures (10 patients, 16.9%), thoracic spine fractures (8 patients, 13.6%), and clavicle fractures (6 patients, 10.2%). Mean age was $50.12{\pm}18.54$ years in the diagnosis group and $57.38{\pm}16.88$ years in the missed fracture group. For the diagnosis group, the mean ISS was $9.03{\pm}8.26$, but in the missed fracture group it was $17.53{\pm}9.69$. Missed fractures were much more frequent in the not-alert mentality (p<0.01) and in the high (ISS$ ISS{\geq}16$) group (p<0.01). Conclusion: Missed fractures occur most frequent in patients of old age, not-alert mentality, and high ISS. Multiple rib and spine fractures were found to be the most frequent missed fractures, regardless of trauma severity. This study also shows a high possibility of clavicle and scapula fractures in patients with severe trauma.

Endoplasmic Reticulum (ER) Stress and Apoptosis in Parthenogenetic Porcine Embryos following Different Combination of Activation Methods

  • Park, Hye-Bin;Park, Yeo-Reum;Lee, Hwa-Yeon;Bae, Hyo-Kyung;Lee, Seunghyung;Park, Choon-Keun;Yang, Boo-Keun;Cheong, Hee-Tae
    • Journal of Embryo Transfer
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    • v.32 no.1
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    • pp.25-31
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    • 2017
  • This study was conducted to investigate the effect of activation method on the endoplasmic reticulum (ER) stress induction, apoptosis and in vitro development of porcine parthenogenetic embryos. Porcine in vitro matured oocytes were activated by four activation methods; 1) electric stimulus (ES) (E), 2) $ES+10{\mu}M$ Ca-ionophore (A23187) treatment (EC), 3) ES+2 mM 6-dimethylaminopurine (6-DMAP) treatment (ED), or 4) ES+A23187 and 6-DMAP treatments (ECD). Parthenogenetic embryos were sampled to analyze x-box binding protein 1 (Xbp1) mRNA, ER stress-associated genes and apoptosis genes at 3 h after ES and the 1-cell and blastocyst stages. In the EC group, the band intensity of spliced Xbp1 (Xbp1s) mRNA was higher than those of the other groups at the 3 h and 1-cell stage, and higher than that of the E group at the blastocyst stage. Four ER stress-associated genes were expressed at the highest level in the EC group and weakly expressed in the ED group at 3 h after activation. However, most of the genes were highly expressed at the 1-cell and blastocyst stages with some variation in the EC and ECD groups. Expression of Bcl-2-associated X protein (Bax) and caspase-3 mRNA was significantly higher in the EC group than in the other groups at all development stages. The developmental rates to the blastocyst stage were higher in the ED and ECD groups than in the E and EC groups. These results suggest that the intracellular ER stress of parthenogenetic porcine embryos is affected by the activation method and subsequently lead to the apoptosis of embryos.

The Study on Accuracy Improvement of Estuary Riverbed Monitoring (하구하상 모니터링 정밀도 향상에 관한 연구)

  • Park, Un-Yong;Kim, Yong-Bo;Back, Ki-Suk
    • Journal of Korean Society for Geospatial Information Science
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    • v.11 no.3 s.26
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    • pp.23-34
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    • 2003
  • Currently, the efficiency of GPS has been increased in the various precise survey like as the control survey and the navigation etc. Also, it is widely used in the deformation analysis of the structure, the measurement of the marine tides, the measurement of the river level and the topographic monitoring of seabed or riverbed by combined the measurement equipment for depth. In this study, we intend to increase in efficiency of the topographic monitoring of seabed or riverbed by combined with DGPS, RTK GPS and echo sounder. For this study, we defined the error correction of the echo sounder with the experiment of water tank which is considered the characteristic of estuary riverbed and then we developed the s/w for 3-dimensional monitoring of estuary riverbed and applied the s/w to field test and improved the various problems. On analyzing topography of estuary riverbed by combined GPS with echo sounder, the draught error which is yielded to change of length from the water surface by the movement of survey vessel to the end of the transducer was eliminated by geometrical rearrangement and we defined the correction formula $z=BM+SAH-DBR_{(i)}-DRT-ED$. The sounding error about the echo sounder and characteristic of estuary riverbed was found by understanding the relation of average diameter ind residual error and we defined correction formula, $Y=0.00474{\ast}ln(X)-0.0045$ by the regression analysis. and then we verified applicability of correction formula.

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A Study on Damage Detection of Cutting Tool Using Neural Network and Cutting Force Signal (신경망과 절삭력신호 특성을 이용한 공구이상상태 감지에 관한 연구)

  • Lim, K.Y.;Mun, S.D.;Kim, S.I.;Kim, T.Y.
    • Journal of the Korean Society for Precision Engineering
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    • v.14 no.12
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    • pp.48-55
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    • 1997
  • A useful method to detect tool breakage suing neural network of cutting force signal is porposed and implemented in a basic cutting process. Cutting signal is gathered by tool dynamometer and normalized as a preprocessing. The cutting force signal level is continually monitored and compared with the predefined level. The neural network has been trained normalized sample data of the normal operation and cata-strophic tool failure using backpropagation learning process. The develop[ed system is verified to be very effective in real-time usage with minor modification in conventional cutting processes.

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Characterization and Mechanical Properties of Silicon Nitride Films with Various Nitrogen Contents (질소함유량에 따른 질화규소 박막의 특성 및 기계적 성질)

  • 고철호;김봉섭;이홍림;윤존도;최성룡;김광호
    • Proceedings of the Materials Research Society of Korea Conference
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    • 2003.03a
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    • pp.209-209
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    • 2003
  • 기계가공용으로 개발된 3성분계 Ti-Si-N 코팅막은 약 40㎬이상의 초고경도이며, 그 미세구조는 나노입자의 TiN결정과 비정질 Si$_3$N$_4$로 이루어져 있다. Ti-Si-N 코팅의 경도는 극소량 Si를 첨가함에 따라 급격히 증가하였으며, 7.7at%에서 약 45㎬이었다. 그 이상에서는 감소하였다. 본 연구는 Ti-Si-N 코팅에서 규소첨가에 따른 박막에 형성하는 질화규소 또는 규소의 특성을 조사하기 위하여 질화규소 박막을 제조하여 그 특성 및 기계적 성질을 조사하였다. 스퍼터링 방법으로 제조한 질화규소 박막의 표면 및 내부구조를 광학현미경, 주사전자현미경, 투과전자현미경 그리고 AFM으로, 정성 및 정량을 EPMA와 EDS로, 결정성을 박막 엑스선회 절분석기로, 화학 결합구조을 XPS으로 분석하였다. 그리고 나노인덴터를 이용하여 박막의 경도와 탄성계수를 조사하였다.

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펄스레이져 증착법을 이용한 자기커패시터용 Pt/CoNiFe/$BaTiO_3$/CoNiFe 박막 제조 및 전.자기 특성 연구

  • Na, Yeo-Jin;Yun, Seong-Uk;Kim, Cheol-Seong;Sim, In-Bo
    • Proceedings of the Materials Research Society of Korea Conference
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    • 2011.05a
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    • pp.240.1-240.1
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    • 2011
  • 본 연구에서는 펄스레이져 박막 증착법(Pulsed Laser Deposition;PLD)을 이용하여 연자성의 CoNiFe (CNF) 물질과 강유전 특성의$BaTiO_3$ (BTO) 물질을 다층박막 구조로 제작하여 약자장(H=200 Oe)에 의해 에너지를 집적 시키거나 유전상수를 조절하여 박막의 구조 변화에 따른 커패시턴스 변화를 연구하였다. 다양한 구조의 다층 박막은 Si/$SiO_2$/Ti/Pt(111) 기판상에 PLD을 이용하여 증착하였으며, Phillp's X-선 회절기 (XRD)를 이용하여 결정구조와 격자 상수를 결정하였다. FE-SEM, TEM, AFM 및 EDS를 이용하여 박막 표면/단면의 미세구조 및 물질에 따른 조성비를 확인하였다. 자기적 특성을 위해Vibrating Sample Magnetometer (VSM)를 측정하였고, 전기적 특성은 LCR meter를 이용하여 측정하였다.

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전기투석과 확산투석을 이용한 공정개발

  • 문승현
    • Proceedings of the Membrane Society of Korea Conference
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    • 1996.10a
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    • pp.8-11
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    • 1996
  • 전기투석은 역삼투압, 한외여과와 함께 가장 많이 이용되고 막공정 중의 하나이다. 전기투석은 다른 막공정과 같이 막의 선택성에 의한 분리조작이며 병렬식 배열에 의한 막의 이용이 가능하고 막오염 현상이 있으며 따라서 막-유체간의 접촉에 대한 제어가 필요하다. 전기투석은 운전목적에 따라 desalting electrodialysis(ED)와 water-splitting electrodiaiysis(WSED)로 구분할 수 있다. Desalting electrodialysis는 고전적 의미의 탈염을 위한 전기투석공정이며 WSED는 bipolar membrane을 이용하여 염을 산과 염기로 분리시키는 기능을 갖는 전기투석 공정을 말한다. WSED는 전기적으로 물을 분리한다는 의미로서 Electrohydrolysis로 불리기도 한다. WSED의 기본원리는 bipolar membrane의 양쪽면에서 수소이옹과 수산이온을 발생시켜 산 또는 염기용액으로 전달하고 bipolar membrane에 접하고 있는 양이온 또는 음이온 교환막에서는 각 용액의 전기적 중성을 유지하기 위해 대응하는 이온을 투과시키는 것이다. WSED는 염으로부터 산 염기제조 뿐만아니라 염의 형태로 생성되는 유기산, 아미노산 등 발효생성물의 회수 또는 acidification에 이용되고 있다.

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An Improvement Performance of S/N Ratio in DMTI System Using Weighted Pulse Trains (Weighting된 펄스 열을 사용하는 DMTI 시스템의 S/N북 개선 특성)

  • Go, Seong-Seon;Lee, Jae-Gyun;Yun, Hyeon-Bae
    • Journal of the Korean Institute of Telematics and Electronics
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    • v.22 no.2
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    • pp.60-65
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    • 1985
  • A method of weighting of a staggered pulse train is presented and an improvement per-formance of the signal-to-noise ratio for each case is compared. As the result of a computer simulation, the signal-to-noise ratio for weighting of a stagger-ed pulse train is a great improvement on the case of an uniform pulse train. The signal-to-noise ratio of optimum weighting is more improved than that of binomial weighting, it is known that the signal-to-noise ratio is improved as the increasing of the number of delay line cancellers, and it is shown that the signal-to-noise ratio is improved by weighting of the MTI output pulses before the integration process.

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저가형 IR Window의 AR Coating 특성 연구

  • Han, Myeong-Su;Park, Chang-Mo;Kim, Jin-Hyeok;Sin, Gwang-Su;Kim, Hyo-Jin;Go, Hang-Ju
    • Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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    • 2010.06a
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    • pp.178-178
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    • 2010
  • 칼코게나이드계 재료를 사용한 비냉각 적외선 센서의 윈도우를 제작하여 그 특성을 조사하였다. 조성을 EDS로 분석한 결과 Ge-Se-Sb로 구성되어 있음을 확인하였다. 두께 2mm인 윈도우 모재를 양면 경연마한 후 코팅 설계치로 8-12um 영역에서 평균 투과도가 95.6%로 나타났다. 이온빔보조증착장치를 이용하여 Ge, ZnS, $YF_3$ 소스로 코팅한 결과 투과도는 동일파장영역에서 약 94%로 나타났다. 칼코게나이드 원재료의 투과도는 약 69%로써 12um 영역 부근에서 강한흡수를 보였다. 코팅면의 거칠기 값(Ra)은 약 1.5 nm로써 매우 매끄러운 면을 얻었으며, 단면 SEM 측정 결과 설계치와 유사한 박막 두께를 얻었다.

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Effective Control of Indoor Air Pollutant using VAV/BPFS (VAV/BPFS를 이용한 실내공기 오염물질의 효율적 제어)

  • 최성우
    • Journal of Environmental Science International
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    • v.7 no.3
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    • pp.327-334
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    • 1998
  • The oil crisis of the 1970s and the rise in oil prices motivated people to implement energy conservation strategies. Buildings were fitted with additional Insulation and reduced ventilation rates. The reduction of mechanical and natural ventilation rate led to Increases In Indoor pollutant concentrations which result- ed In Increased health risks from Indoor exposure to pollutants. The variable-air-volume /bypass fitration system/VAV/BPFS) is a variation of the conventional VAV systems, The VAV/BPFS is an electronically controlled system that provides costegectlve thermal comfort and acceptable indoor air quality Under controlled conditions In a chamber, a series experiments were performed to compare the ability of a VAV/BPFS to remove Indoor aerosol concentration and to reduce energy consumption no that ability of conventional VAV system. Results show that the VAV/BPFS Increases the effective ventilation rate and removes indoor air pollutant, and maintains acceptable indoor air Quality without sacrificing energy consumption.

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