Despite aggressive treatment, the mortality rate of cardiogenic shock with acute myocardial infarction (AMI) is high. We performed extracorporeal membrane oxygenation (ECMO) prior to coronary reperfusion, and evaluated the early clinical results and risk factors. Materials and Methods: From May 2006 to November 2009, we reviewed the medical records of 20 patients in cardiogenic shock with AMI (mean age $67.7{\pm}11.7$ yrs, M : F 14 : 6). After initially performing ECMO using the CAPIOX emergency bypass system ($EBS^{(R)}$Terumo, Tokyo, Japan), patients underwent coronary reperfusion (coronary artery bypass grafting, 13; percutaneous coronary intervention, 7). Results: All patients were in a cardiogenic shock state, cardiopulmonary resuscitations (CPR) were performed for fourteen patients (mean CPR time $20.8{\pm}26.0$ min). The mean time from vascular access to the initiation of ECMO was $17.2{\pm}9.4$ min and mean support time was $3.8{\pm}4.0$ days. Fourteen patients were able to be weaned from ECMO and ten patients were discharged (mean admission duration $50.1{\pm}31.6$ days). Patients survived on average $476.6{\pm}374.6$ days of follow-up. Longer CPR and support time, increased cardiac enzyme, lower ejection fraction, lower albumin, and major complications were the risk factors of mortality (p<0.05). Conclusion: The early application of ECMO prior to coronary reperfusion and control of risk factors allowed for good clinical results in cardiogenic shock with AMI.
Journal of Korea Technical Association of The Pulp and Paper Industry
/
v.41
no.4
/
pp.43-51
/
2009
Paper mill sludges are discharged around 870,000 M/T annually. Only 30% of the paper mill sludge have been recycled and the rest has been disposed by land fill, incineration, ocean abandonment and other ways. Because of overall prohibition of sludge disposal by London Dumping Convention in 2012, a urgent counter measure for paper mill sludge must be provided. In this paper, some basic experiments were carried out to develop a tray cell pot using paper mill sludge for increasing the recycling potential of the wasted sludge. To establish the manufacturing parameters, the tray cell pots were made with three types of materials including virgin pulp, old news paper and corrugated board mixed in a blend tank of a molding machine. The bending force and moisture content of the produced tray cell pots was measured to confirm the application capability. The tray cell pot could be manufactured under the condition of over 20% of virgin pulp, 40% of old news paper added. However, the corrugated board could not be used because of the glutinous substance included. The produced tray cell pot absorbed water very easily and the bending force decreased rapidly. The waterproof material must be used to applicate the produced tray cell pot in plant growing fields.
Background: Although previously studies have reported that most patients with malignancy prefer to die at home, this is not the real situation in clinical practice. Aim: In this study, we aimed to determine the characteristics of Turkish cancer patients admitted to the emergency department (ED) within one month before death. Materials and Method: This descriptive retrospective study focused on questions about how often and why patients with cancer visited the ED before death. A total of 107 individuals with cancer were divided into 2 groups: Group 1, patients with at least one visit in the final 4 weeks; and Group 2, patients with no visit to ED. Demographic and clinical features were compared between the two groups. Statistical analyses: Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression were used. Results: At least one visit to ED within one month before death was reported for 64 (60%) of the 107 cases. Of these 64 (Group 1), 38% (n=24) were discharged and 9% (n=6) died in the ED. The most common site of the primary tumor was the lung (n=24, 38%) and the most common symptom was dyspnea (92%). With the other 43 (40%) cancer patients not presenting to the ED within one month before death, they were more likely to be female with another type of cancer. Conclusions: Guidelines are needed for better management of cancer patients benefiting from visits to ED within the last month of life.
Choi, Ji Woo;Xuan, Yi;Hur, Hoon;Byun, Cheul Su;Han, Sang-Uk;Cho, Yong Kwan
Journal of Gastric Cancer
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v.13
no.2
/
pp.98-105
/
2013
Purpose: The aim of this study is to investigate the clinical factors affecting on the cure rate by invasive and open surgery for gastric cancer and to establish a subgroup of patients who can be applied by the early recovery after surgery program through this retrospective analysis. Materials and Methods: In this retrospective study, we analyzed 425 patients who underwent gastric cancer surgery between January 2011 and December 2011 and were managed with conventional clinical therapies. This clinical algorithm was made when the patient was in minimally invasive surgery group and discharged from hospital one day faster than them in open surgery group. Results: The completion rate of the clinical pathway was 62.4%. Despite the different applications of clinical pathway, completion rate in minimally invasive surgery group was significantly higher than that of open group (P<0.001). In multivariate analysis, the surgical procedure of minimally invasive surgery (odds ratio=4.281) was the most predictable factor to complete clinical pathway. Additionally, younger patients (odds ratio=1.933) who underwent distal gastrectomy (odds ratio=1.999) without combined resection (odds ratio=3.069) were predicted to accomplish the clinical pathway without any modifications. Conclusions: We concluded that high efficacy of the clinical pathway for gastric cancer surgery was expected to selected patients through retrospective analysis (expected completion rate=85.4%). In addition, these patients would become enrolled criteria for early recovery program in gastric cancer surgery.
Khan, Sara;Khan, Naveed Ali;Rehman, Ata Ur;Khan, Iqra;Samo, Khursheed A;Memon, Amjad Siraj
Asian Pacific Journal of Cancer Prevention
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v.17
no.3
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pp.1337-1340
/
2016
Background: There is a noticeable change in the approach with which women nowadays seek help for diseases like breast cancer, primarily due to awareness campaigns, but what happens after surgical procedures is of great significance too. This study focused on the several psychological connotations attached to mastectomy and how the patients cope. Objective: To understand the pattern of anxiety and level of depression among Pakistani patients undergoing mastectomy. Materials and Methods: The sample size consisted of 88 patients who had undergone mastectomy at the different surgical units of the Civil Hospital, Karachi, from January 2012-December 2014; The questionnaire was administered before they were discharged i.e. within 3 days of surgical procedures. The patients were asked if they were willing to participate in this study, those who agreed signed the consent form and then we preceded by asking questions with a standardized tool. A self made questionnaire was constructed keeping in mind the nature and specification of the disease, which consisted of 20 questions related to anxiety and depression, focusing on a mixture of psychological and physiological symptoms. Results: There were a total of 88 patients out of which 36 (41%) were aged 51 to 60 years, 24 (27.2%) of the patients were in the age category of 41 to 50 years, 17 aged 61 and above (19.3%) and only 11 (12.5%) 30-40 years of age, the youngest of all the age categories. The pattern of depression and anxiety was found to be similar among all age categories, severe depression and anxiety predominating over moderate level of such symptoms, with only relatively few patients sufering mild or no depression symptoms. Conclusions: It was concluded that going through mastectomy leads to moderate to severe levels of depression and anxiety, primarily because the females feel incomplete and insecure after losing a part of themselves.
There are several steps such as slicing, lapping, chemical etching and mechanical polishing in the silicon wafer production process. The chemical etching step is necessary to remove damaged layer caused In the slicing and lapping steps. The typical etching liquor is the acid mixture comprising nitric acid, acetic acid and hydrofluoric acid. At present, the waste acid is treated by a neutralization method with a high alkali cost and balky solid residue. A solvent extraction method is applicable to separate and recover each acid. Acetic acid is first separated from the waste liquor using 2-ethlyhexyl alcohols as an extractant. Then, nitric acid is recovered using TBP(Tri-butyl phosphate) as an extractant. Finally hydrofluoric acid is separated with the TBP solvent extraction. The expected recovered acids in this process are 2㏖/l acetic acid, 6㏖/1 nitric acid and 6㏖/l hydrofluoric acid. The yields of this process are almost 100% for acetic acid and nitric acid. On the other hand, it is important to recover and reuse the metal values contained in various industrial wastes in a viewpoint of environmental preservation. Most of industrial products are made through the processes to separate impurities in raw materials, solid and liquid wastes being necessarily discharged as industrial wastes. Chemical methods such as solvent extraction, ion exchange and membrane, and physical methods such as heavy media separation, magnetic separation and electrostatic separation are considered as the methods for separation and recovery of the metal values from the wastes. Some examples of the application of solvent extraction to the treatment of wastes such as Ni-Co alloy scrap, Sm-Co alloy scrap, fly ash and flue dust, and liquid wastes such as plating solution, the rinse solution, etching solution and pickling solution are introduced.
Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and acounts for 6% to 15% of all cases of childhood cancer, Rhabdomyosarcoma in seventh most common form of childhood neoplasms, following acute leukemia, tumors of the central nervous system, lymphoma neuroblastoma, Wilm`s tumor, bone tumor. Rhabdomyosarcoma can arise anywhere in the body, but primary site in the thorax is relatively rare. We experienced a case of aveolar rhabdomyosarcoma arising from intercostal muscle, A 12 year-old woman was suffered from the intermittent left chest pain radiating to the scapular area and dyspnea, On physical examination, pulmonary friction rub was heard on the left upper lobe area. Qn adimission, the chest simple radiography revealed a 7 x 6, 5cm sized radio-opaque mass with pleural effusion in the superior mediastinum and the CT showed a well difined radio-opaque mass including the destructed 2nd rib and pleural effusion. The percutaneous tra-nsthoracic needle aspiration biopsy was likely to show blastoma. After the chemotherapy[vincristine, actinomycin-D, cyclophosphamde] was done to treat blastoma, the pleural effussion was subsided and the mass was slightly decreased by 4.5x 4. 5cm. For treatment and diagnosis, we performed en-bloc resection and the defected chest was reconstucted with Gortex patch. Grossly, the specimen was colored graysh-white and arised in between two ribs The microscopic findings showed that the tumor cells were small round with scant pinkish cytoplasm on the H-E stain and the tumor cell nests were grouped by reticulum fibers and showed alveolar pattern on the silver stain The electromicroscopic finding presented that the cytoplasm contained tangled fibrillar and flocculent materials. The histopathologic findings were compatable with laveolar rhabdomyosarcoma. She was discharged without any complication. After discharge, she has been treated with radiation theraphy and chemotheraphy, and not recurred untill last follow-up We report a case of alveolar rhabdomyosarcoma arising to intercostal muscle, developed in 12 year-old waman, with brief review of literatures.
Kim, Woo-Ram;Jo, Young-Min;Lee, Heon-Seok;Oh, Soo-Kwan
Journal of the Korean Applied Science and Technology
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v.32
no.1
/
pp.48-55
/
2015
IMO to issue some restricted maritime legislation for reducing the adverse environmental impacts arising from such ship exhaust emissions. According to the IMO policy, every ship entering the Baltic SECAs has to equip the gas cleaning scrubber. The discharged waste solution by gas cleaning scrubber contains many types of salts, which to recover some valuable materials before disposal. This study try to achieve valuable salts including AN and AS throughout a few process such as selective organic solvents salting out, low temperature extraction and thermal evaporation. Amongst them, Thermal evaporation with repetition extraction using inorganic solvent was the most optimum to purify the extracted AN. This valuable salt was evaluated by Elemental analysis and Differential scanning calorimetry.
This study was conducted from August, 1980 to March, 9991 to the 40 subjects who were admitted to Kosin Medical Center and received rehabilitation treatment and discharged under the impression of stroke. The objectives are to evaluate the function of the activites of daily living and comprehensive function and find the status of rehabilitation treatment by Modified Barthel Index and PULSES Profile when first requested or rehabilitation treatment(T1), at 2 weeks after rehabilitation treatment(T2), at discharge(T3) and at the time of ambulatory treatment after 2 weeks(T4). The study materials were clinical charts and functional evaluation sheets, and the results are as follows : 21 subject$(52.5\%)$ were male, 19 subjects$(47.5\%)$ were female, and the age distribution was from 19 to 70 in age, the average age was 52.7. By the classification of diagnosis, 21 subjects$(52.5\%)$ were cerebral hemorrhage, 8 subjects$(20.2\%)$ were cerebral thrombosis, 6 subjects$(15.0\%)$ were cerebral embolism, and 5 subjects$(12.5\%)$ were cerebral infarction. The Barthel Index scores were 35.7, 54.5, 71.8, 88.7 on the average at T1, T2, T3, T4 respectively. The PULSES scores were 16.4, 13.7, 11.4, 8.7 on the average at T1, T2, T3, T4 respectively. Regarding the Pearson's correlation coefficient between the Barthel Index scores and the PULSES scores, it was -0.7991(P>0.001) at T1 and -0.8986(P>0.001) at T3, then beth of correlations were very high.
To create a large-scale complex, it is often the case to perform ground improvement by using vertical drain method after the reclamation of coastal soft ground, for construction period shortening and stable site renovation. During this process, the pore water migrates to the horizontal drainage layer of the ground surface through the vertical drain installed in the soft ground and discharged out to the open. In the past sand was used as the material for the horizontal drainage layer in numerous cases, however recently, due to material shortage and high pricing, the use of crushed stones has increased. To prevent mixing of the materials between the horizontal drainage layer and the upper landfill, geosynthetics (PPMat) are installed. However, the use of geosynthetics results in high additional cost for material purchase and installation, therefore it is necessary to examine the validity of the installation itself. In this study, to verify the necessity, model tests were performed. Results from the model tests indicate that the drainage ability of the horizontal drainage layer is barely affected by the application of geosynthetics.
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