• Title/Summary/Keyword: 지표효과

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A study of the plan dosimetic evaluation on the rectal cancer treatment (직장암 치료 시 치료계획에 따른 선량평가 연구)

  • Jeong, Hyun Hak;An, Beom Seok;Kim, Dae Il;Lee, Yang Hoon;Lee, Je hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.171-178
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    • 2016
  • Purpose : In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). Materials and Methods : The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has $0^{\circ}$, $270^{\circ}$, $90^{\circ}$ and $0^{\circ}$, $95^{\circ}$, $45^{\circ}$, $315^{\circ}$, $265^{\circ}$ gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar $360^{\circ}$ 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H.I. of the PTV among three plans. Total MU showed that the VMAT treatment plan used 124.4MU and 299MU more than the 3fCRT and 5fCRT treatment plan, respectively. IMRT verification gamma test results for the VMAT plan passed over 90.0% at 2mm/2%. Conclusion : In rectal cancer treatment, the VMAT plan was shown to be advantageous in most of the evaluation indexes compared to the 3D plan, and the dose of the femoral head was greatly reduced. However, because of practical limitations there may be a case where it is difficult to select a VMAT treatment plan. 5fCRT has the advantage of reducing the dose of the femoral head as compared to the existing 3fCRT, without regard to additional problems. Therefore, not only would it extend survival time but the quality of life in general, if hospitals improved radiation therapy efficiency by selecting the treatment plan in accordance with the hospital's situation.

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A Study on Intelligent Value Chain Network System based on Firms' Information (기업정보 기반 지능형 밸류체인 네트워크 시스템에 관한 연구)

  • Sung, Tae-Eung;Kim, Kang-Hoe;Moon, Young-Su;Lee, Ho-Shin
    • Journal of Intelligence and Information Systems
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    • v.24 no.3
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    • pp.67-88
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    • 2018
  • Until recently, as we recognize the significance of sustainable growth and competitiveness of small-and-medium sized enterprises (SMEs), governmental support for tangible resources such as R&D, manpower, funds, etc. has been mainly provided. However, it is also true that the inefficiency of support systems such as underestimated or redundant support has been raised because there exist conflicting policies in terms of appropriateness, effectiveness and efficiency of business support. From the perspective of the government or a company, we believe that due to limited resources of SMEs technology development and capacity enhancement through collaboration with external sources is the basis for creating competitive advantage for companies, and also emphasize value creation activities for it. This is why value chain network analysis is necessary in order to analyze inter-company deal relationships from a series of value chains and visualize results through establishing knowledge ecosystems at the corporate level. There exist Technology Opportunity Discovery (TOD) system that provides information on relevant products or technology status of companies with patents through retrievals over patent, product, or company name, CRETOP and KISLINE which both allow to view company (financial) information and credit information, but there exists no online system that provides a list of similar (competitive) companies based on the analysis of value chain network or information on potential clients or demanders that can have business deals in future. Therefore, we focus on the "Value Chain Network System (VCNS)", a support partner for planning the corporate business strategy developed and managed by KISTI, and investigate the types of embedded network-based analysis modules, databases (D/Bs) to support them, and how to utilize the system efficiently. Further we explore the function of network visualization in intelligent value chain analysis system which becomes the core information to understand industrial structure ystem and to develop a company's new product development. In order for a company to have the competitive superiority over other companies, it is necessary to identify who are the competitors with patents or products currently being produced, and searching for similar companies or competitors by each type of industry is the key to securing competitiveness in the commercialization of the target company. In addition, transaction information, which becomes business activity between companies, plays an important role in providing information regarding potential customers when both parties enter similar fields together. Identifying a competitor at the enterprise or industry level by using a network map based on such inter-company sales information can be implemented as a core module of value chain analysis. The Value Chain Network System (VCNS) combines the concepts of value chain and industrial structure analysis with corporate information simply collected to date, so that it can grasp not only the market competition situation of individual companies but also the value chain relationship of a specific industry. Especially, it can be useful as an information analysis tool at the corporate level such as identification of industry structure, identification of competitor trends, analysis of competitors, locating suppliers (sellers) and demanders (buyers), industry trends by item, finding promising items, finding new entrants, finding core companies and items by value chain, and recognizing the patents with corresponding companies, etc. In addition, based on the objectivity and reliability of the analysis results from transaction deals information and financial data, it is expected that value chain network system will be utilized for various purposes such as information support for business evaluation, R&D decision support and mid-term or short-term demand forecasting, in particular to more than 15,000 member companies in Korea, employees in R&D service sectors government-funded research institutes and public organizations. In order to strengthen business competitiveness of companies, technology, patent and market information have been provided so far mainly by government agencies and private research-and-development service companies. This service has been presented in frames of patent analysis (mainly for rating, quantitative analysis) or market analysis (for market prediction and demand forecasting based on market reports). However, there was a limitation to solving the lack of information, which is one of the difficulties that firms in Korea often face in the stage of commercialization. In particular, it is much more difficult to obtain information about competitors and potential candidates. In this study, the real-time value chain analysis and visualization service module based on the proposed network map and the data in hands is compared with the expected market share, estimated sales volume, contact information (which implies potential suppliers for raw material / parts, and potential demanders for complete products / modules). In future research, we intend to carry out the in-depth research for further investigating the indices of competitive factors through participation of research subjects and newly developing competitive indices for competitors or substitute items, and to additively promoting with data mining techniques and algorithms for improving the performance of VCNS.

Effect of Physical Training on Electrocardiographic Amplitudes and the QRS Vector (체력단련(體力鍛練)이 심전도파고(心電圖波高)와 QRS벡타에 미치는 효과(效果))

  • Yu, Wan-Sik;Hwang, Soo-Kwan;Kim, Hyeong-Jin;Choo, Young-Eun
    • The Korean Journal of Physiology
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    • v.18 no.1
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    • pp.51-65
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    • 1984
  • In an effort to elucidate the effect of physical training on the electrocardiographic amplitudes, QRS vector, axis and QRS vector amplitude, electrocardiograms were recorded before and 1, 5 and 10 minutes after 3 minute rebounder exercise in 23 healthy male students aged between 18 and 21 years in two groups of athletes and non-athletes. ECG amplitudes were measured from lead I, $V_1$ and $V_5$ and axis and amplitudes of QRS vectors were measured from lead I and III in frontal plane, from lead $V_2$ and lead $V_6$ in horizontal plane. The results obtained are summarized as follows. ECG amplitudes: The R wave amplitude was $23.38{\pm}1.14\;mm$ in athletes which was higher than $17.91{\pm}2.00\;mm$ in non-athletes. After exercise, the difference in two groups remained significant throughout the recovery period. The S wave amplitude was increased significantly, and the T wave amplitude was decreased in both groups after exercise. The P wave amplitude was increased in both groups after exercise, and it was lower in athletes than in non-athletes. The PQ segment amplitude was zero in athletes but negative in non-athletes than in the resting state. The J point amplitude was positive in resting state and was negative after exercise in both groups. J+0.08 sec point amplitude was also lowered after exercise, and it was higher in athletes than in non-athletes. Therefore the whole ST segment was proved to be decreased after exercise. The summated amplitude of R in $V_5$ plus S in $V_1$ was $38.74{\pm}2.71\;mm$ in athletes which was higher than $32.82{\pm}2.90\;mm$ in non-athletes. After exercise, it was also significantly higher in athletes than in non-athletes. Axis of QRS vector: In frontal plane, axis of QRS vector was $62.7{\pm}7.36^{\circ}$ in athletes, it showed no significant difference between the two groups. In horizontal plane, axis of QRS vector was $-23.5{\pm}7.2^{\circ}$ in athletes which was significantly higher than $-38.8{\pm}8.2^{\circ}$ in non-athletes. After exercise, it was significantly higher than the resting state in both groups. Amplitude of QRS vector : In frontal plane, amplitude of QRS vector was $13.86{\pm}1.44\;mm$ in athletes which was significantly higher than $9.62{\pm}0.97\;mm$ in non-athletes. After exercise, it was also significantly higher in athletes than in non-athletes. In horizontal plane, amplitude of QRS vector was $19.82{\pm}2.10\;mm$ in athletes which was significantly higher than $16.90{\pm}1.39\;mm$ in non-athletes. After exercise, it was also significantly higher in athletes than in non-athletes. From the above, these results indicate that R wave amplitude in athletes was significantly higher than in non-athletes before and after exercise, and that the summated amplitude of R in $V_5$ plus S in $V_1$ in athletes was also $38.74{\pm}2.71\;mm$ suggesting a left ventricular hypertrophy We should note that the PQ segment and ST segment amplitude were higher in athletes than in non-athletes, and they were decreased with exercise in both groups. In particular, the fact that amplitudes of QRS vector in frontal plane or in horizontal plane were significantly greater in athletes than in non-athletes may be an index in evaluating athletes.

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Evaluation of Sodium Intake and Relationship between Sodium Intake and the Bone Mineral Density of Female University Students (중부 지역 여대생에서 음식섭취빈도조사지를 이용한 나트륨 섭취량 평가 및 나트륨 섭취와 골밀도와의 관련성 조사)

  • Bae, Yun-Jung;Yeon, Jee-Young
    • Journal of the East Asian Society of Dietary Life
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    • v.21 no.5
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    • pp.625-636
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    • 2011
  • The purpose of this study was to evaluate the relationship between bone health and sodium intake in female university students using a dish frequency questionnaire (DFQ 125), anthropometric checkups, food records for 3 days, and ultrasound measurement of calcaneus bone mineral density. Subjects were divided into two groups: normal (n=196) and osteopenia (n=52). There were no significant differences in age or height between the two groups. The average weight, body mass index, and body fat in the normal group were significantly higher than in the osteopenia group. The sodium intake of DFQ was positively correlated with the sodium intake of 3 days of dietary records (p=0.0003). There were no significant differences in the sodium intake between the two groups from DFQ. The dishes were ranked by sodium intake: kimchies were 17.68%, noodles and mandu were 16.36%, stews were 13.69%, main dishes such as meat, egg, and beans were 11.47%, and fish and shellfish were 11.07%. The frequency of eating noodles and mandu (p=0.0116), stews (p=0.0008), kimchies (p=0.0482), fish and shellfish (p=0.0362), vegetables (p=0.0064) and seasoning (p=0.0347) were negatively associated with bone mineral density. Bone health was not significantly different with increasing quartiles of sodium intake. As excessive sodium intakes may indirectly affect bone mineral density, these results suggest that to prevent osteoporosis, university students needed to be more educated about diets containing less sodium through nutrition education programs.

Korean Sentence Generation Using Phoneme-Level LSTM Language Model (한국어 음소 단위 LSTM 언어모델을 이용한 문장 생성)

  • Ahn, SungMahn;Chung, Yeojin;Lee, Jaejoon;Yang, Jiheon
    • Journal of Intelligence and Information Systems
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    • v.23 no.2
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    • pp.71-88
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    • 2017
  • Language models were originally developed for speech recognition and language processing. Using a set of example sentences, a language model predicts the next word or character based on sequential input data. N-gram models have been widely used but this model cannot model the correlation between the input units efficiently since it is a probabilistic model which are based on the frequency of each unit in the training set. Recently, as the deep learning algorithm has been developed, a recurrent neural network (RNN) model and a long short-term memory (LSTM) model have been widely used for the neural language model (Ahn, 2016; Kim et al., 2016; Lee et al., 2016). These models can reflect dependency between the objects that are entered sequentially into the model (Gers and Schmidhuber, 2001; Mikolov et al., 2010; Sundermeyer et al., 2012). In order to learning the neural language model, texts need to be decomposed into words or morphemes. Since, however, a training set of sentences includes a huge number of words or morphemes in general, the size of dictionary is very large and so it increases model complexity. In addition, word-level or morpheme-level models are able to generate vocabularies only which are contained in the training set. Furthermore, with highly morphological languages such as Turkish, Hungarian, Russian, Finnish or Korean, morpheme analyzers have more chance to cause errors in decomposition process (Lankinen et al., 2016). Therefore, this paper proposes a phoneme-level language model for Korean language based on LSTM models. A phoneme such as a vowel or a consonant is the smallest unit that comprises Korean texts. We construct the language model using three or four LSTM layers. Each model was trained using Stochastic Gradient Algorithm and more advanced optimization algorithms such as Adagrad, RMSprop, Adadelta, Adam, Adamax, and Nadam. Simulation study was done with Old Testament texts using a deep learning package Keras based the Theano. After pre-processing the texts, the dataset included 74 of unique characters including vowels, consonants, and punctuation marks. Then we constructed an input vector with 20 consecutive characters and an output with a following 21st character. Finally, total 1,023,411 sets of input-output vectors were included in the dataset and we divided them into training, validation, testsets with proportion 70:15:15. All the simulation were conducted on a system equipped with an Intel Xeon CPU (16 cores) and a NVIDIA GeForce GTX 1080 GPU. We compared the loss function evaluated for the validation set, the perplexity evaluated for the test set, and the time to be taken for training each model. As a result, all the optimization algorithms but the stochastic gradient algorithm showed similar validation loss and perplexity, which are clearly superior to those of the stochastic gradient algorithm. The stochastic gradient algorithm took the longest time to be trained for both 3- and 4-LSTM models. On average, the 4-LSTM layer model took 69% longer training time than the 3-LSTM layer model. However, the validation loss and perplexity were not improved significantly or became even worse for specific conditions. On the other hand, when comparing the automatically generated sentences, the 4-LSTM layer model tended to generate the sentences which are closer to the natural language than the 3-LSTM model. Although there were slight differences in the completeness of the generated sentences between the models, the sentence generation performance was quite satisfactory in any simulation conditions: they generated only legitimate Korean letters and the use of postposition and the conjugation of verbs were almost perfect in the sense of grammar. The results of this study are expected to be widely used for the processing of Korean language in the field of language processing and speech recognition, which are the basis of artificial intelligence systems.

Parents' Opinions on Foodservices in Daycare Centers of Korea's Compensation and Welfare Service Institute (근로복지공단 보육시설의 급식 운영현황과 학부모대상 품질 만족도)

  • Kim, Ji Hyeon;Lee, Young Eun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.1
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    • pp.102-113
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    • 2013
  • The purpose of this study was to examine parental perceptions on the importance, performance level, and satisfaction with foodservice quality at daycare centers in the Compensation and Welfare Service institute. The questionnaire was developed to measure thirty-two attributes of foodservice operations are administered to 598 parents and 23 foodservice supervisors from June 22, 2009 to July 10, 2009. The parents placed a high importance on the need for foodservices, earning 4.70 points out of 5 points. Their perceptions of foodservice quality menu, foodservice ingredients and effects, facilities, sanitation, and service scored even higher than performance. The overall satisfaction level for foodservice compared to performance was 4.33 and 4.03 points out of 5 points, respectively. Multiple regression analysis indicated that 98.6% of the variance in parents' overall satisfaction scores was explained by six dimensions.

The Comparison of Image Quality and Quantitative Indices by Wide Beam Reconstruction Method and Filtered Back Projection Method in Tl-201 Myocardial Perfusion SPECT (Tl-201 심근관류 SPECT 검사에서 광대역 재구성(Wide Beam Reconstruction: WBR) 방법과 여과 후 역투영법에 따른 영상의 질 및 정량적 지표 값 비교)

  • Yoon, Soon-Sang;Nam, Ki-Pyo;Shim, Dong-Oh;Kim, Dong-Seok
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.122-127
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    • 2010
  • Purpose: The Xpress3.$cardiac^{TM}$ which is a kind of wide beam reconstruction (WBR) method developed by UltraSPECT (Haifa, Israel) enables the acquisition of at quarter time while maintaining image quality. The purpose of this study is to investigate the usefulness of WBR method for decreasing scan times and to compare to it with filtered back projection (FBP), which is the method routinely used. Materials and Methods: Phantom and clinical studies were performed. The anthropomorphic torso phantom was made on an equality with counts from patient's body. The Tl-201 concentrations in the compartments were 74 kBq (2 ${\mu}Ci$)/cc in myocardium, 11.1 kBq (0.3 ${\mu}Ci$)/cc in soft tissue, and 2.59 kBq (0.07 ${\mu}Ci$)/cc in lung. The non-gated Tl-201 myocardial perfusion SPECT data were acquired with the phantom. The former study was scanned for 50 seconds per frame with FBP method, and the latter study was acquired for 13 seconds per frame with WBR method. Using the Xeleris ver. 2.0551, full width at half maximum (FWHM) and average image contrast were compared. In clinical studies, we analyzed the 30 patients who were examined by Tl-201 gated myocardial perfusion SPECT in department of nuclear medicine at Asan Medical Center from January to April 2010. The patients were imaged at full time (50 second per frame) with FBP algorithm and again quarter-time (13 second per frame) with the WBR algorithm. Using the 4D MSPECT (4DM), Quantitative Perfusion SPECT (QPS), and Quantitative Gated SPECT (QGS) software, the summed stress score (SSS), summed rest score (SRS), summed difference score, end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were analyzed for their correlations and statistical comparison by paired t-test. Results: As a result of the phantom study, the WBR method improved FWHM more than about 30% compared with FBP method (WBR data 5.47 mm, FBP data 7.07 mm). And the WBR method's average image contrast was also higher than FBP method's. However, in result of quantitative indices, SSS, SDS, SRS, EDV, ESV, EF, there were statistically significant differences from WBR and FBP(p<0.01). In the correlation of SSS, SDS, SRS, there were significant differences for WBR and FBP (0.18, 0.34, 0.08). But EDV, ESV, EF showed good correlation with WBR and FBP (0.88, 0.89, 0.71). Conclusion: From phantom study results, we confirmed that the WBR method reduces an acquisition time while improving an image quality compared with FBP method. However, we should consider significant differences in quantitative indices. And it needs to take an evaluation test to apply clinical study to find a cause of differences out between phantom and clinical results.

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Evaluation of Standardized Uptake Value and Metabolic Tumor Volume between Reconstructed data and Re-sliced data in PET Study (PET 검사 시 Reconstructed data와 Re-sliced data의 표준섭취계수와 Metabolic Tumor Volume의 비교 평가)

  • Do, Yong Ho;Lee, Hong Jae;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.3-8
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    • 2016
  • Purpose SUV is one of the parameters that assist diagnosis in origin, metastasis and staging of cancer. Specially, it is important to compare SUV before and after chemo or radiation therapy to find out effectiveness of treatment. Storing PET data which has no quantitative change is needed for SUV comparison. However, there is a possibility to loss the data in external hard drive or MINIpacs that are managed by department of nuclear medicine. The aim of this study is to evaluate SUV and metabolic tumor volume (MTV) among reconstructed data (R-D) in workstation, R-D and re-sliced data (S-D) in PACS. Materials and Methods Data of 20 patients (aged $60.5{\pm}8.3y$) underwent $^{18}F-FDG$ PET (Biograph truepoint 40, mCT 40, mCT 64, mMR, Siemens) study were analysed. $SUV_{max}$, $SUV_{peak}$ and MTV were measured in liver, aorta and tumor after sending R-D in workstation, R-D and S-D in PACS to syngo.via software. Results R-D of workstation and PACS showed the same value as mean $SUV_{max}$ in liver, aorta and tumor were $2.95{\pm}0.59$, $2.35{\pm}0.61$, $10.36{\pm}6.15$ and $SUV_{peak}$ were $2.70{\pm}0.51$, $2.07{\pm}0.43$, $7.67{\pm}3.73$(p>0.05) respectively. Mean $SUV_{max}$ of S-D in PACS were decreased by 5.18%, 7.22%, 12.11% and $SUV_{peak}$ 2.61%, 3.63%, 10.07%(p<0.05). Correlation between R-D and S-D were $SUV_{max}$ 0.99, 0.96, 0.99 and $SUV_{peak}$ 0.99, 0.99, 0.99. And 2SD in balnd-altman analysis were $SUV_{max}$ 0.125, 0.290, 1.864 and $SUV_{peak}$ 0.053, 0.103, 0.826. MTV of R-D in workstation and PACS show the same value as $14.21{\pm}12.72cm^3$(p>0.05). MTV in PACS was decreased by 0.12% compared to R-D(p>0.05). Correlation and 2SD between R-D and S-D were 0.99 and 2.243. Conclusion $SUV_{max}$, $SUV_{peak}$, MTV showed the same value in both of R-D in workstation and PACS. However, there was statistically difference in $SUV_{max}$, $SUV_{peak}$ of S-D compare to R-D despite of high correlation. It is possible to analyse reliable pre and post SUV if storing R-D in main hospital PACS system.

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Effect of Repetitive Transcranial Magnetic Stimulation in Drug Resistant Depressed Patients (치료 저항성 우울증 환자에서 반복적 경두개 자기자극후 국소뇌혈류 변화)

  • Chung, Yong-An;Yoo, Ie-Ryung;Kang, Bong-Joo;Chae, Jeong-Ho;Lee, Hye-Won;Moon, Hyun-Jin;Kim, Sung-Hoon;Sohn, Hyung-Sun;Chung, Soo-Kyo
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.9-15
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    • 2007
  • Purpose: Repetitive transcranial magnetic stimulation (rTMS) has recently been clinically applied in the treatment of drug resistant depressed patients. There are mixed findings about the efficacy of rTMS on depression. Furthermore, the influence of rTMS on the physiology of the brain is not clear. We prospectively evaluated changes of regional cerebral blood flow (rCBF) between pre- and post-rTMS treatment in patients with drug resistant depression. Materials and Methods: Twelve patients with drug-resistant depression (7 male, 5 female; age range: $19{\sim}52$ years; mean age: $29.3{\pm}9.3$ years) were given rTMS on right prefrontal lobe with low frequency (1 Hz) and on left prefrontal lobe with high frequency (20 Hz), with 20-minute-duration each day for 3 weeks. Tc-99m ECD brain perfusion SPECT was obtained before and after rTMS treatment. The changes of cerebral perfusion were analyzed using statistical parametric mapping (SPM; t=3.14, uncorrected p<0.01, voxel=100). Results: Following areas showed significant increase in rCBF after 3 weeks rTMS treatment: the cingulate gyrus, fusiform gyrus of right temporal lobe, precuneus, and left lateral globus pallidus. Significant decrement was noted in: the precental and middle frontal gyrus of right frontal lobe, and fusiform gyrus of left occipital lobe. Conclusion: Low-frequency rTMS on the right prefrontal cortex and high-frequency rTMS on the left prefrontal cortex for 3 weeks as an add-on regimen have increased and decreased rCBF in the specific brain regions in drug-resistant depressed patients. Further analyses correlating clinical characteristics and treatment paradigm with functional imaging data may be helpful in clarifying the pathophysiology of drug-resistant depressed patients.

A Study on the Effects of the Early Use of Nasal CPAP in the Weaning of Mechanical Ventilators (인공호흡기 이탈시 비강내 CPAP 조기 사용 효과에 관한 연구)

  • Kim, Yeoung Ju;Jung, Byun Kyung;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1200-1206
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    • 2003
  • Purpose : This study was conducted for the use of nasal continuous positive airway pressure (CPAP), by comparing the early use of non-invasive nasal CPAP with low intermittent mandatory ventilation(low IMV) and endotracheal CPAP in weaning a mechanical ventilator from infants with moderate respiratory distress syndrome(RDS). Methods : Thirty infants in the study group, with moderate RDS from November 2001 to June 2002, were administered surfactants and treated with the mechanical ventilator, and applied the nasal CPAP in weaning. Thirty infants of the control group, from January 1999 to September 2001, were applied low IMV and endoctracheal CPAP in weaning. Results : There were no significant differences in the characteristics, the severity of clinical symptoms, the initial laboratory findings and settings of the mechanical ventilator. After weaning, the study group showed no significant changes in $PaCO_2$. However, the control group showed a slight $CO_2$ retension after one and 12 hours. Twenty eight infants(93.3%) of the study group and 24 infants(80%) of the control group were successfully extubated. The primary cause of failure was apnea. There were no significant differences in the duration of weaning and the mechanical ventilator treatment between the groups. Complications in weaning were related to the fixation of nasal CPAP and the mechanical problems caused by endotracheal tube. Conclusion : Aggressive weaning is possible for moderate RDS, in which the nasal CPAP was used without the low IMV and the endotracheal CPAP process. It had no difficulties. In conclusion, the nasal CPAP is an adequate weaning method for moderate RDS.