• Title/Summary/Keyword: Adequate access

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Prostatic Artery Embolization for Lower Urinary Tract Symptoms via Transradial Versus Transfemoral Artery Access: Single-Center Technical Outcomes

  • Ryun Gil;Dong Jae Shim;Doyoung Kim;Dong Hwan Lee;Jung Jun Kim;Jung Whee Lee
    • Korean Journal of Radiology
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    • v.23 no.5
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    • pp.548-554
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    • 2022
  • Objective: To evaluate the safety and feasibility of prostatic artery embolization (PAE) via transradial access (TRA) compared with transfemoral access (TFA). Materials and Methods: This retrospective study included 53 consecutive men with lower urinary tract symptoms (LUTS) who underwent PAE between September 2018 and September 2021. Thirty-one patients (mean age ± standard deviation: 70.6 ± 8.4 years) were treated with TFA, including 14 patients treated before adopting TRA. Since December 2019, TRA has also been attempted with the procedure's selection criteria of patent carpal circulation and a height ≤ 172 cm, with 22 patients treated via TRA (69.1 ± 9.6 years). Parameters of technical success (defined as successful bilateral embolization), clinical success (defined as LUTS improvement), procedural time, radiation dose, and adverse events were compared between the two groups using the Fisher's exact test, independent sample t test, Wilcoxon signed-rank test, or Mann-Whitney test. Results: All patients received at least one-side PAE. Technical success of PAE was achieved in most patients (TRA, 21/22; TFA, 30/31; p > 0.999). No technical problem-related conversion from TRA to TFA occurred. The clinical success rate was 85% (11/13) in patients with TRA, and 89% (16/18) in patients with TFA for follow-up > 2 weeks post-PAE (median, 3 months) (p > 0.999). The median procedure time was similar in both groups (TRA, 81 minutes vs. TFA, 94 minutes; p = 0.570). No significant dose differences were found between the TRA and TFA groups in the dose-area product (median Gycm2, 95 [range, 44-255] for TRA and 84 [34-255] for TFA; p = 0.678) or cumulative air kerma (median mGy, 609 [236-1584] for TRA and 634 [217-1594] for TFA; p = 0.551). No major adverse events occurred in either of the groups. Conclusion: PAE via TRA is a safe and feasible method comparable to conventional TFA. It can be safely implemented by selecting patients with patent carpal circulation and adequate height.

Determination of Adequate Method for Protein Extraction from Rice Bran and the Substitution of Dried Skim Milk with Protein Concentrate from Rice Bran in Early Weaned Pigs

  • Phipek, W.;Nagasinha, C.;Vallisuth, S.;Nongyao, C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.24 no.9
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    • pp.1268-1273
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    • 2011
  • The present study was conducted to determine a feasible method of protein concentrate extraction from rice bran (RBPC) and its effect as a substitution for skim milk in early weaning pig diets. An investigation to extract protein concentrate from full fat rice bran was undertaken to determine the best ratio of water and rice bran, the amount of NaOH and a HCl solvent to use in a simple paddle-type mixer with modified spinning to produce RBPC. The results stated that the best ratio for water mixing in the RBPC extraction process was 1:5 with 20 g NaOH and 30 min in a paddle-type mixer at 300 rpm. A mix of 250 ml 0.2 N HCl was optimum for neutralization and protein precipitation. After the fluid was spun out with a washing machine, the sediment was left for 12-14 hours to complete the filtration. One kilogram of rice bran could produce an average of 324.5 gram RBPC and it contained 3.40% ash, 496.48 kcal of GE/100 gram, 1.94% crude fiber, 28.20% ether extract, 7.64% moisture and 16.66% crude protein, respectively. A total of 45 crossbred piglets, weaned at 3 weeks of age were allotted into control diet (A) and dietary treatments formulated with a four different rates of RBPC substitution for skim milk at a percentage of 25 (B), 50 (C), 77 (D) and 100 (E) respectively, in a randomized complete block (RCB) design. All piglets had free access to feed and water until 8 week of age when the experiment ended. Feed intake, average daily gain, growth rate and feed efficiency were not affected by dietary treatments. Blood test parameters after completion of the growth trial indicated normal health. Even though the mean of cell hemoglobin concentration was significantly different between treatments (p<0.05) it was still within the normal range. The cost difference for BW gain of 100% RBPC substituted for skim milk in the weaning diet was approximately 35% lower than that of the control and the relative cost of production was 96.67, 92.85, 70.75 and 64.48% lower for the replacement of 25, 50, 75 and 100% of skim milk respectively. These results implied that this technology is feasible for use by small scale farmers to improve their self-reliance.

The relationship between household income and dietary intakes of 1-10 year old urban Malaysian

  • Shariff, Zalilah Mohd;Lin, Khor Geok;Sariman, Sarina;Lee, Huang Soo;Siew, Chin Yit;Yusof, Barakatun Nisak Mohd;Mun, Chan Yoke;Mohamad, Maznorila
    • Nutrition Research and Practice
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    • v.9 no.3
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    • pp.278-287
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    • 2015
  • BACKGROUND/OBJECTIVES: Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status. SUBJECTS/METHODS: Children's dietary intakes were obtained using food recall and record for two days. Diet adequacy was assessed based on recommended intakes of energy and nutrients and food group servings. RESULTS: For toddlers, all nutrients except dietary fiber (5.5 g) exceeded recommended intakes. Among older children (preschoolers and school children), calcium (548 mg, 435 mg) and dietary fiber (7.4 g, 9.4 g) did not meet recommendations while percentage of energy from total fat and saturated fats exceeded 30% and 10%, respectively. The mean sodium intakes of preschoolers (1,684 mg) and school children (2,000 mg) were relatively high. Toddlers in all income groups had similar energy and nutrient intakes and percentages meeting the recommended intakes. However, low income older children had lowest intakes of energy (P < 0.05) and most nutrients (P < 0.05) and highest proportions that did not meet recommended energy and nutrient intakes. For all food groups, except milk and dairy products, all age groups had mean intakes below the recommended servings. Compared to middle and high income groups, low income preschoolers had the lowest mean intake of fruits (0.07 serving), meat/poultry (0.78 serving) and milk/dairy products (1.14 serving) while low income toddlers and school children had the least mean intake of fruits (0.09 serving) and milk/dairy products (0.54 serving), respectively. CONCLUSION: Low socioeconomic status, as indicated by low household income, could limit access to adequate diets, particularly for older children. Parents and caregivers may need dietary guidance to ensure adequate quantity and quality of home food supply and foster healthy eating habits in children.

Clinical Analysis of Arteriovenous Fistula Using Perforating Vein on Antecubital Fossa (팔 오금에서 시행한 관통정맥을 이용한 동정맥루 조성술의 임상적 고찰)

  • Choi, Kwang-Ho;Yoon, Young-Chul;Lee, Yang-Haeng;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.642-647
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    • 2010
  • Background: It is very important to obtain vascular access that resists repeated punctures and maintains an adequate blood flow for performing hemodialysis in patients with ESRD. This study was designed to identify the risk factors that may influence the patency rate of arteriovenous fistula (AVF) using perforating vein on antecubital fossa. Material and Method: We analyzed 205 cases of AVF in 195 patients who underwent hemodialysis access surgery on antecubital fossa in our hospital from May 2006 to December 2009. Result: The patency rate of AVF from 6 months after surgery using perforating vein was 75.91%. The risk factors that influence the patency rate was age. There was no statistic difference between used vessels. Conclusion: The patency of the AVF using perforating vein on antecubital fossa was comparable. The condition of sex and location and presence or absence of diabetes and hypertension and other cardio-neurovascular disease did not make statistically significant effect on the AVF patency rate. The age was an independent risk factor for patency rate.

Nurse Practitioner Roles and Curriculums in the United States (미국 전문간호사(NP)의 역할과 교육과정에 관한 고찰)

  • Lee Sun-Ock
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.97-105
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    • 1999
  • Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

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Performance Improvement of Downlink Real-Time Traffic Transmission Using MIMO-OFDMA Systems Based on Beamforming (Beamforming 기반 MIMO-OFDMA 시스템을 이용한 하향링크 실시간 트래픽 전송 성능 개선)

  • Yang Suck-Chel;Park Dae-Jin;Shin Yo-An
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.43 no.3 s.345
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    • pp.1-9
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    • 2006
  • In this paper, we propose a MIMO-OFDMA (Multi Input Multi Output-Orthogonal Frequency Division Multiple Access) system based on beamforming for performance improvement of downlink real-time traffic transmission in harsh channel conditions with low CIR (Carrier-to-Interference Ratio). In the proposed system, we first consider the M-GTA-SBA (Modified-Grouped Transmit Antenna-Simple Bit Allocation) using effective CSI (Channel State Information) calculation procedure based on spatial resource grouping, which is adequate for the combination of MRT (Maximum Ratio Transmission) in the transmitter and MRC (Maximum Ratio Combining) in the receiver. In addition, to reduce feedback information for the beamforming, we also apply QEGT (Quantized Equal Gain Transmission) based on quantization of amplitudes and phases of beam weights. Furthermore, considering multi-user environments, we propose the P-SRA (Proposed-Simple Resource Allocation) algorithm for fair and efficient resource allocation. Simulation results reveal that the proposed MIMO-OFDMA system achieves significant improvement of spectral efficiency in low CRI region as compared to a typical open-loop MIMO-OFDMA system using pseudo-orthogonal space time block code and H-ARQ IR (Hybrid-Automatic Repeat Request Incremental Redundancy).

Measurement of Dust Concentration in a Naturally Ventilated Broiler House according to Season and Worker's Access (윈치커튼식 계사의 시기 및 작업자 출입에 따른 분진 발생 농도 측정 연구)

  • Jo, Ye-seul;Kwon, Kyeong-seok;Lee, In-bok;Ha, Tae-hwan;Park, Se-jun;Kim, Rack-woo;Yeo, Uk-hyeon;Lee, Sang-yeon;Lee, Seung-no
    • Journal of The Korean Society of Agricultural Engineers
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    • v.57 no.6
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    • pp.35-46
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    • 2015
  • Improvement in domestic poultry production has a positive effect on the export competitiveness of the poultry industry. However, overproduction and enlargement of facilities to assure a supply increase a stocking density which make a poor environment in the broiler house. In particular, an intensive rearing environment is vulnerable to dust control that causes respiratory diseases, such as asthma, bronchitis, etc., to farmers and broilers. However, monitoring data and research for environment control are not adequate, and there are no air quality regulations in broiler houses in Korea. In this study, TSP, PM10, inhalable dust and respirable dust concentration were monitored according to season, age of broiler and broiler's activities. Air quality assessment was also performed in accordance with the threshold limit value by Donham et al. (2000). The TSP concentrations were 77.5 %, 219.7 % higher and PM10 concentrations were 121.2 %, 303.8 % higher when change of season and winter respectively than summer. There were significantly different concentrations according to season and age of broiler. Inhalable and respirable dust concentration were also clearly different according to the season and age of broiler. A high dust concentration was observed, specifically exceeding the threshold limit by 119 % in the winter. In the case of the broiler's motion was activity according to worker's access into the broiler house, concentration level was 769.6 % higher than broiler's motion was stable and exceeded the threshold limit. These results suggest that the worker should put on protective equipment to protect there's respiratory health in the broiler house.

Computerization of Nurse Staffing and Scheduling according to Patient Classification (환자분류에 의한 간호인력 산정 및 배치과정 전산화)

  • Park, Jung-Ho;Park, Hyeoun-Ae;Cho, Hyon;Choi, Yong-Sun
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.399-412
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    • 1996
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current nursing productivity of nurses is not desirable unless the quality of care considered. Moreover. nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. As for the nurse scheduling, the critical problem of it in the hospital is determining the day-to-day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. Nurse scheduling, however, involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. Under these backgrounds, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. This study was performed to develop a system computerizing nurse staffing and scheduling based on the patient classification. As a preliminary step for the system development, nursing workload in a secondary hospital was measured from Sep. to Oct. 1994. On the grounds of this result, computerization of nurse staffing and scheduling was proceeded with three options. First one is based on the current medical law. Second one is based on the assigned number of nursing staff. And the last is based on the request by patient classification. Computer languages used in this study were MS Visual Basic 3.0 for the staffing and Access 2.0 for the scheduling, respectively. Prospective users may operate this system easily because icons and mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurse administrators manage nursing manpower efficiently and nurses develop quick and easy schedule generation and allow more time for the patient care.

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Conservative Endodontic Treatment of Type III Dens Invaginatus : Case Report (Type III 치내치의 보존적 근관치료 : 증례보고)

  • Jo, Wansun;Lee, Nanyoung;Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.2
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    • pp.174-179
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    • 2014
  • Dens invaginatus is a developmental anomaly resulting from an infolding of the enamel organ into the dental papilla prior to calcification of the dental tissue. Clinical and radiographic presentation of dens invaginatus shows a lot of variation. The classification proposed by Oehlers(1957) is most commonly used among classifications of dens invaginatus. Several treatments have been suggested to treat Type III dens invaginatus where the pulp remains healthy but the invagination is associated with a periodontitis. The top priority objective is to preserve pulp as sound as possible. Thus, if there is no definite evidence of pulpal disease, the conservative access which treat invagination as distinct from the pulp is necessary. But, Endodontic treatment of Type III dens invaginatus has the particular problems associated with achieving adequate chemomechanical debridement of the root canal system and invagination, predictable length control and consistent filling. In this case report, the endodontic treatment limited within invagination was performed for treatment of Type III dens invaginatus, and filling with Mineral Trioxide Aggregate(MTA) resulted in good prognosis.

A Study for Joint Freezing in Concrete Pavement (콘크리트포장의 줄눈의 잠김에 대한 연구)

  • Lee, Seung-Woo
    • International Journal of Highway Engineering
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    • v.3 no.1 s.7
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    • pp.165-176
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    • 2001
  • Joints in jointed concrete Pavement are designed to control against randomly occurred cracks within slabs, which may be caused by temperature or moisture variation. The advantage of these artificial cracks (joints) over naturally occurred cracks are easy access of protections, such as installation of joint seal and load transfer mechanism. The potential benefits of joint seals are to prevent infiltration of surface water through the joint into underlying soil and intrusion of incompressible materials (debris, fine size aggregate) in to the joint, which may prevent weakening of underlying soils and spallings due to excessive compressive stress, respectively. For the adequate design of joint seal, horizontal variation of joint widths (horizontal joint movements) are essential inputs. Based on long-term in-situ joint movement data of sixteen jointed concrete pavement sections in Long Term Performance Pavement Seasonal Monitoring Program (LTPP SMP), it was indicated that considerable Portion of joints showed no horizontal movements with change in temperature. This Phenomenon is called 'Joint Freezing'. Possible cause for joint freezing is that designed penetrated cracks do not occur at a joint. In this study, a model for the prediction of the ratio of freezing joints in a particular pavement sections is proposed. In addition, possible effects of joint freezing against pavement performance are addressed.

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