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Clinical Characteristics and Prognosis of Acinetobacter Nosocomial Pneumonia between MDR and non-MDR (Acinetobacter 병원내 폐렴에서 다제 내성군과 약제 감수성군 간의 임상적 특징과 예후)

  • Park, In-Il;Kim, Ick-Keun;Koo, Hyun-Cheol;Han, Jae-Pil;Kim, Young-Mook;Lee, Myung-Goo;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.13-19
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    • 2006
  • Background: Acinetobacter baumannii has emerged as an important nosocomial pathogen worldwide. The incidence of these infections has recently begun to increase. The mortality rate associated with these infections is high (bacteremia; 52%, pneumonia: 23%~73%) and multidrug resistance has been reported. For the effective control of multidrug-resistant Acinetobacter baumannii(MDR-AB), the impact of these organisms in clinical practice should be determined. This study compared the clinical characteristics, mortality and morbidity of Acinetobacter nosocomial pneumonia between MDR strain and non-MDR strain. Methods: From Jan. 1, 2002 to Nov. 1. 2004, 47 adult patients with Acinetobacter nosocomial pneumonia in Chuncheon Sacred Heart Hospital were recruited and analyzed retrospectively. MDR-AB was defined as showing in vitro resistance to all commercially available antibiotics against A. baumannii. Results: There were 47 patients with Acinetobacter nosocomial pneumonia. MDR-AB and non MDR-AB was the cause of the pneumonia in 17 and 30 patients, respectively. Mean age of the former was $69{\pm}11$ years old and the latter was $70{\pm}13$ years old. The mean APCHE II score, ICU days and mortality were not different between the two groups ($16.1{\pm}5.4$ vs. $14.9{\pm}4.8$, P=0.43, $25.1{\pm}13.6$ vs. $39.1{\pm}31.0$, P=0.2, 58.8% vs. 40%, P=0.21). Conclusion: There are no significant differences in mortality and morbidity between MDR and non-MDR Acinetobacter baumannii. The mortality of the two groups is surprisingly high, therefore proper infection control practices are essential.

A STUDY ON THE MEASUREMENT OF THE IMPLANT STABILITY USING RESONANCE FREQUENCY ANALYSIS (공진 주파수 분석법에 의한 임플랜트의 안정성 측정에 관한 연구)

  • Park Cheol;Lim Ju-Hwan;Cho In-Ho;Lim Heon-Song
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.2
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    • pp.182-206
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    • 2003
  • Statement of problem : Successful osseointegration of endosseous threaded implants is dependent on many factors. These may include the surface characteristics and gross geometry of implants, the quality and quantity of bone where implants are placed, and the magnitude and direction of stress in functional occlusion. Therefore clinical quantitative measurement of primary stability at placement and functional state of implant may play a role in prediction of possible clinical symptoms and the renovation of implant geometry, types and surface characteristic according to each patients conditions. Ultimately, it may increase success rate of implants. Purpose : Many available non-invasive techniques used for the clinical measurement of implant stability and osseointegration include percussion, radiography, the $Periotest^{(R)}$, Dental Fine $Tester^{(R)}$ and so on. There is, however, relatively little research undertaken to standardize quantitative measurement of stability of implant and osseointegration due to the various clinical applications performed by each individual operator. Therefore, in order to develop non-invasive experimental method to measure stability of implant quantitatively, the resonance frequency analyzer to measure the natural frequency of specific substance was developed in the procedure of this study. Material & method : To test the stability of the resonance frequency analyzer developed in this study, following methods and materials were used : 1) In-vitro study: the implant was placed in both epoxy resin of which physical properties are similar to the bone stiffness of human and fresh cow rib bone specimen. Then the resonance frequency values of them were measured and analyzed. In an attempt to test the reliability of the data gathered with the resonance frequency analyzer, comparative analysis with the data from the Periotest was conducted. 2) In-vivo study: the implants were inserted into the tibiae of 10 New Zealand rabbits and the resonance frequency value of them with connected abutments at healing time are measured immediately after insertion and gauged every 4 weeks for 16 weeks. Results : Results from these studies were such as follows : The same length implants placed in Hot Melt showed the repetitive resonance frequency values. As the length of abutment increased, the resonance frequency value changed significantly (p<0.01). As the thickness of transducer increased in order of 0.5, 1.0 and 2.0 mm, the resonance frequency value significantly increased (p<0.05). The implants placed in PL-2 and epoxy resin with different exposure degree resulted in the increase of resonance frequency value as the exposure degree of implants and the length of abutment decreased. In comparative experiment based on physical properties, as the thickness of transducer increased, the resonance frequency value increased significantly(p<0.01). As the stiffness of substances where implants were placed increased, and the effective length of implants decreased, the resonance frequencies value increased significantly (p<0.05). In the experiment with cow rib bone specimen, the increase of the length of abutment resulted in significant difference between the results from resonance frequency analyzer and the $Periotest^{(R)}$. There was no difference with significant meaning in the comparison based on the direction of measurement between the resonance frequency value and the $Periotest^{(R)}$ value (p<0.05). In-vivo experiment resulted in repetitive patternes of resonance frequency. As the time elapsed, the resonance frequency value increased significantly with the exception of 4th and 8th week (p<0.05). Conclusion : The development of resonance frequency analyzer is an attempt to standardize the quantitative measurement of stability of implant and osseointegration and compensate for the reliability of data from other non-invasive measuring devices It is considered that further research is needed to improve the efficiency of clinical application of resonance frequency analyzer. In addition, further investigation is warranted on the standardized quantitative analysis of the stability of implant.

Thyroglossal Duct Cyst and Fistula (갑상설관 낭포 및 루)

  • 최종욱;김한상;안문성;김춘길;주양자
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.10-10
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    • 1981
  • The thyroglossal duct cyst is relatively rare disease that derived congenitally from the remnant of thyroglossal duct and that was found anywhere from the foramen cecum to pyramidal lobe of thyroid. We studied the 62 cases of above disease who admitted and operated at E.N.T. dept. of N.M.C. for 20 years since 1961 to 1980 on the clinical and histopathological aspect, and we concluded following results. 1. In the age distribution, 45 cases(72.6%) were under 20 years, and in the age distribution of the known on-set of symptoms, 26 cases(58.0%) were under 10 years. In the duration, 23 cases(37.0%) were under 1 year. The sex ratio of male to female revealed 1.2:1. 2. The palpable mass were complained at 48 cases(77.4%) and 14 cases(22.6%) complained of the discharge from sinus tracts and the other complaints were dysphagia and odynophagia, etc. 3. In location 55 cases (88.7%) were at midline, 1 case(1.6%) was at right and 6 cases(9.7%) were left sided. And 47 cases(75.8%) were situated at infrahyoid region, 11 cases(17.7%) at suprahyoid, 3 cases(4.8%) at suprasternal, only 1 case(1.6%) at intralingual region. 4. In 27 cases formed fistulae, spontaneous occurrance were 7 cases and artificial occurrance were 20 cases. 5. In histopathologically among 41 cases preserving available slides, 5 cases(12.2%) had single duct and 20 cases(48.8%) had multiple accessory ducts, but 16 cases were impossible to detect the ducts. The lining epithelium composed of chiefly respiratory and squamous epithelium. 15 cases had inflammatory reaction at periductal area and 7 cases had around the cysts. The ectopic thyroid tissue was found on 6 cases(14.6%) and 1 case had the follicular adenoma. 6. In the recurrance rate among 43 cases performed sistrunk type operation, 2 cases (4.6%) recurred, and among 19 cases performed simple removal of cysts, 4 cases (21.1%) recurred.

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Adenoid Cystic Carcinoma of the Head and Neck (두경부의 Adenoid Cystic Carcinoma)

  • 박준식;설대위
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.14.2-14
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    • 1981
  • In 1859, Billroth used the term "Zylindrome" to describe a tumor arising in the paranasal sinuses. This neoplasm has been referred to by a variety of terms including cylindroma, basaloma, basaloid adenoma, cribriform adenocarcinoma, and "adenoid cystic carcinoma", now preferred by most authors. It most often arises in the major and minor salivary glands of the head and neck but has been noted in the trachea, lung, breast, skin and elsewhere. The tumors are characterized by a high incidence of local recurrence and ultimate distant metastases after agrressive attempts at surgical excision. Radiation therapy, while not curative, has proved uniformly useful in promoting tumor regression and pain relief as a palliative treatment. The present study was undertaken to review our experience with a group of 44 patients with adenoid cystic carcinoma of the head and neck, diagnosed at the Jeonju Presbyterian Medical Center between 1963 and 1980. The results are as follows: 1. Forty-four cases of adenoid cystic carcinoma represented 40% of the malignant salivary gland tumors during the same interval. 2. The most common primary sites were palate(8 cases) and submandibular gland (8 cases). 3. Thirteen patients (31%) had tumors. that arose in the major salivary glands; 29 (69%), minor salivary glands. 4. Of the 44 patients, there were 21 males. and 23 females. 5. Age at diagnosis ranged from 19 to 78 years; the average age was 50 years. 6. The tumor size was more than 4cm to 6cm in its greatest diamension in 10 patients. Clinically positive cervical lymph nodes were found in 7 patients; distant metastasis in one case at the time of diagnosis. 7. Radical excision was employed in 27 patients, 14 of whom combined with radiotherapy. 8. Of 29 patients available for follow-up the gross and determinate 3-year survival rates were 27.6% and 44.4%, respectively. Among twelve patients who received radical excision, the 3-year survival was 58%. 9. Ten of these 44 patients had local recurrence in an interval of 3 to 88 months. from the initial treatment. Of ten recurrences, 3 occured after 5 years. 10. Distant metastasis was found in 3 of the treated patients. All were pulmonary metastasis.

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Prognostic Factors of Advanced Gastric Cancer Patients without Lymph Node Metastasis (림프절 전이가 없는 진행성 위암의 예후 인자)

  • Kang, Sang-Yoon;Kim, Se-Won;Song, Sun-Kyo;Kim, Sang-Woon
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.124-131
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    • 2007
  • Purpose: This study was conducted to identify prognostic factors in gastric cancer without lymph node metastasis and to specifiy which prognostic factors can be available in detail according to the depth of invasion. Materials and Methods: This retrospective study was based on the medial records of 268 gastric cancer patients who received resectional therapy from 1990 to 1999. The patients who revealed pT2NOMO, pT3NOMO, pT4NOMO on postoperative pathologic reports were enrolled. The survival rate was analyzed according to clinicopathologic and therapeutic factors. Results: According to the depth of invasion, the number of patients with pT2a, pT2b, pT3 and pT4 were 86 (32.1%), 56 (20.9%), 108 (40.3%), and 18 (6.7%) respectively. Age, depth of invasion, histological type, Borrmann type, and Lauren classification were statistically significant in the univariate analysis, and the age, the depth of invasion, and Lauren classification were independent prognostic factors identified by multivariate analysis. On multivariate analysis of subgroups according to the depth of invasion, the independent prognostic factors were age, Borrmann type, and Lauren classification in pT2, and age, Lauren classification, and vascular invasion in pT3. The prognostic factors of pT4 patients could not be analyzed due to limited sample size. Conclusion: In advanced gastric cancer patients without lymph node metastasis, age, the depth of invasion, and Lauren classification should be checked to predict prognosis. In patients with pT2 lesion among the above patients, the Borrmann type should be added in check-list.

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Effect of TGF-${\beta}$ Supplementation on In Vitro Maturation of Hanwoo COCs (Cumulus Oocytes Complexes) (TGF- ${\beta}$ 첨가가 한우 난포란의 체외성숙에 미치는 영향)

  • Choi, Sun-Ho;Lee, Hye-Hyun;Yeon, Seong-Heum;Han, Man-Hye;Kim, Hyun-Jong;Cho, Sang-Rae;Woo, Jae-Seok;Baek, Kwang-Soo;Ryu, Il-Sun;Son, Dong-Soo
    • Development and Reproduction
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    • v.8 no.2
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    • pp.119-122
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    • 2004
  • It is well known that unidentified factors in sera, hormones and growth factors promote the proliferation of granulosa cells and nuclear maturation of bovine COCs in vitro. Attemps had been developed the simple composition of culture media and similar system to in vivo conditions has been applied. In the present study, we investigated the effect of TGF-${\beta}$ on in vitro maturation and in vitro development of Hanwoo COCs. When the COCs were matured in TCM 199 containing 0.1, 1 or 10 ng/ml TGF-${\beta}$ for 24 hrs, metaphaseⅡ of COCs were obtained 95.8%, 100% of matured COCs, respectively and there were no differences among the concentrations of TGF-${\beta}$. Matured COCs with TGF-${\beta}$ cultured in maturation medium after in vitro fertilization, developmental rate to blastocyst were 0~0.8%. Matured COCs with TGF-${\beta}$ were cultured in TCM 199+10% FBS, 0.8% BSA, 0.1% PVA, blastocyst formation were showed in 12.4%, 12.8%, 8.5% of those and cultured in IVMD or IVD without serum were 38.4%, 34.8%, respectively. There were significant differences among the media (P<0.05). TGF-${\beta}$ is available for i vitro maturation of bovine COCs, but further investigation would be need for finding the synergistic autocrine/paracrine fashion of other growth factors in early bovine development.

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Genotype Frequencies of the Sex-Linked Feathering and Their Phenotypes in Domestic Chicken Breeds for the Establishment of Auto-Sexing Strains (자가성감별 계통 조성을 위한 국내 토종 닭의 깃털 조만성 양상과 유전자형 빈도)

  • Sohn, Sea-Hwan;Park, Dhan-Bee;Song, Hae-Ran;Cho, Eun-Jung;Kang, Bo-Seok;Suh, Ok-Suk
    • Journal of Animal Science and Technology
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    • v.54 no.4
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    • pp.267-274
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    • 2012
  • The method of sexing based on differences in the rate of feather growth provides a convenient and inexpensive approach. The locus of feather development gene (K) is located on the Z chromosome and can be utilized to produce phenotypes that distinguish between the sexes of chicks at hatching. To establish the auto-sexing native chicken strains, this study analyzed the genotype frequency of the feathering in domestic chicken breeds. The method of classification of slow- and rapid-feathering chickens was also investigated. In the slow-feathering chicks, the coverts were either the same length or longer than the primary wing feathers at hatching. However, the rapid-feathering chicks had the primary wing feathers that were longer than the coverts. The growth pattern of tail feather also distinctively differed between the rapid- and slow-feathering chicks after 5-days. The accuracy of wing feather sexing was about 98% compared with tail sexing. In domestic chicken breeds, Korean Black Cornish, Korean Rhode Island Red, and Korean Native Chicken-Red had both dominant (K) and recessive ($k^+$) feathering genes. The other breeds of chickens, Korean Brown Cornish, Ogol, White Leghorn, Korean Native Chicken-Yellow, -Gray, -White and -Black had only the recessive feathering gene ($k^+$). Consequently, feather sexing is available using the domestic chicken breeds. Establishing the maternal stock with dominant gene (K-) and paternal stock with recessive gene ($k^+k^+$), the slow-feathering characteristic is passed from mothers to their sons, and the rapid-feathering characteristic is inherited by daughters from their fathers.

Development and Application of the High Speed Weigh-in-motion for Overweight Enforcement (고속축하중측정시스템 개발과 과적단속시스템 적용방안 연구)

  • Kwon, Soon-Min;Suh, Young-Chan
    • International Journal of Highway Engineering
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    • v.11 no.4
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    • pp.69-78
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    • 2009
  • Korea has achieved significant economic growth with building the Gyeongbu Expressway. As the number of new road construction projects has decreased, it becomes more important to maintain optimal status of the current road networks. One of the best ways to accomplish it is weight enforcement as active control measure of traffic load. This study is to develop High-speed Weigh-in-motion System in order to enhance efficiency of weight enforcement, and to analyze patterns of overloaded trucks on highways through the system. Furthermore, it is to review possibilities of developing overweight control system with application of the HS-WIM system. The HS-WIM system developed by this study consists of two sets of an axle load sensor, a loop sensor and a wandering sensor on each lane. A wandering sensor detects whether a travelling vehicle is off the lane or not with the function of checking the location of tire imprint. The sensor of the WIM system has better function of classifying types of vehicles than other existing systems by detecting wheel distance and tire type such as single or dual tire. As a result, its measurement errors regarding 12 types of vehicle classification are very low, which is an advantage of the sensor. The verification tests of the system under all conditions showed that the mean measurement errors of axle weight and gross axle weight were within 15 percent and 7 percent respectively. According to the WIM rate standard of the COST-323, the WIM system of this study is ranked at B(10). It means the system is appropriate for the purpose of design, maintenance and valuation of road infrastructure. The WIM system in testing a 5-axle cargo truck, the most frequently overloaded vehicle among 12 types of vehicles, is ranked at A(5) which means the system is available to control overloaded vehicles. In this case, the measurement errors of axle load and gross axle load were within 8 percent and 5 percent respectively. Weight analysis of all types of vehicles on highways showed that the most frequently overloaded vehicles were type 5, 6, 7 and 12 among 12 vehicle types. As a result, it is necessary to use more effective overweight enforcement system for vehicles which are seriously overloaded due to their lift axles. Traffic volume data depending upon vehicle types is basic information for road design and construction, maintenance, analysis of traffic flow, road policies as well as research.

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Development of Dynamic Kidney Phantom System and its Evaluation of Usability of Application in Nuclear Medicine (핵의학 동적 신장팬텀시스템 개발 적용의 유용성 평가)

  • Park, Hoon-Hee;Lee, Juyoung;Kim, Sang-Wook;Lyu, Kwang Yeul;Jin, Gye Hwan
    • Journal of radiological science and technology
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    • v.36 no.1
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    • pp.49-55
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    • 2013
  • Currently, commercially available phantom can reproduce and evaluate only a static situation, the study is incomplete research on phantom and system which is can confirmed functional situation in the kidney by time through dynamic phantom and blood flow velocity, various difference according to the amount of radioactive. Therefore, through this study, it has produced the dynamic kidney phantom to reproduce images through the dynamic flow of the kidney, it desires to evaluate the usefulness of nuclear medicine imaging. The production of the kidney phantom was fabricated based on the normal adult kidney, in order to reproduce the dynamic situation based on the fabricated kidney phantom, in this study, it was applied the volume pump that can adjust the speed of blood flow, so it can be integrated continuously radioactive isotopes in the kidney by using $^{99m}Tc$-pertechnate. Used the radioactive isotope was supplied through the two pump. It was confirmed the changes according to the infusion rate, radioactive isotopes and the different injection speeds on the left and right, analysis of the acquired images was done by drawn five times ROI in order to check the reproducibility of each on the front and rear of the kidney and bladder. Depending on the speed of injection, radioisotope was a lot of integrated and emissions up when adjusting the pressure of the pump as 30 stroke, it was the least integrated and emissions up when adjusting as 40 stroke. The integration of the left & right kidney was not reached in the amount of the highest when adjusting as 10 stroke. In the changes according to the amount of the radioactive isotope, 0.6 mCi(22.2 MBq), 0.8 mCi (29.6 MBq)was showed up similar tendency but, in the result of the different injection 0.8 mCi, it was showed up counts close to double of 0.6 mCi. In the result of the differently injection speed of the left & right kidney, as a result of different conditions that injection speed was 20 stroke through left kidney phantom, the injection speed was 30 stroke through right kidney phantom, it was enough difference in the resulting image can be easily distinguished with the naked eye. Through this study, the results showed that the dynamic kidney phantom system is able to similarly reproduce renogram in the actual clinical practice. Especially, the depicted over time for the flow to be excreted through the kidney into the bladder was adequately reproduce, it is expected to be utilized as basic data to check the quality of the dynamic images. In addition, it is considered to help in the field of functional imaging and quality control.

Comparison of VATS with Thoracotomy for the Treatment of Spontaneous Pneumothorax (자발성 기흉의 치료에서의 비디오 흉강경 수술과 개흉술의 비교)

  • 김문수;김영태;김기봉;김원곤;성숙환;김주현
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.294-298
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    • 1999
  • Background: Video-assisted thoracoscopic surgery(VATS) has been established as a new method for treatment of spontaneous pneumothorax. We compared the clinical results of VATS with those of thoracotomy performed during the recent 5 years. Material and Method: We analyzed 126 patients whose medical records were available among the 154 patients who underwent operations for spontaneous pneumothorax from 1992 to 1996. The mean age was 27.1 years(15 to 75 years). 87 patients were operated on by VATS(Group A) and the other 39 by thoracotomy(Group B). The mean follow-up period was 14.7 months. Result: The operation time was shorter in group A than in group B(90.6${\pm}$38.6minutes: 117.2${\pm}$58.9minutes, p<0.05). The duration of postoperative hospital stay was shorter in group A than in group B(6.7${\pm}$4.2: 9.4${\pm}$3.3 days, p<0.05). The amount of analgesics(nalbuphin HCl, ketoprofen) used postoperatively were 2.4${\pm}$2.8 ampules in group A, which is less than the 6.5${\pm}$5.6 ampules in group B(p<0.05). The number of staples used in group A was smaller(2.7${\pm}$1.3 in group A, 1.76${\pm}$1.1 in group B, p<0.05). The duration of chest tube indwelling(4.3${\pm}$4.0 days in group A, and 5.6${\pm}$3.0 days in group B, NS), the recurrence rate(13.8% in group A, 2.6% in group B, NS), and the duration of air leakage(1.3${\pm}$3.3 days in group A, and 1.0${\pm}$2.5days in group B, NS) were not statistically different between the two groups. Conclusion: The application of VATS for the treatment of spontaneous pneumothorax has brought in better clinical results(shorter operation time, shorter hospital stay, less pain, and better cosmetic merits) than the thoracotomy without increasing any morbidity. However no advantages in recurrence rates and duration of postoperative air leakages are revealed.

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