• Title/Summary/Keyword: Effect ratio

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A Randomized Phase III Study of Patients With Advanced Gastric Adenocarcinoma Without Progression After Six Cycles of XELOX (Capecitabine Plus Oxaliplatin) Followed by Capecitabine Maintenance or Clinical Observation

  • Guk Jin Lee;Hyunho Kim;Sung Shim Cho;Hyung Soon Park;Ho Jung An;In Sook Woo;Jae Ho Byun;Ji Hyung Hong;Yoon Ho Ko;Der Sheng Sun;Hye Sung Won;Jong Youl Jin;Ji Chan Park ;In-Ho Kim;Sang Young Roh;Byoung Yong Shim
    • Journal of Gastric Cancer
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    • v.23 no.2
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    • pp.315-327
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    • 2023
  • Purpose: Oxaliplatin, a component of the capecitabine plus oxaliplatin (XELOX) regimen, has a more favorable toxicity profile than cisplatin in patients with advanced gastric cancer (GC). However, oxaliplatin can induce sensory neuropathy and cumulative, dose-related toxicities. Thus, the capecitabine maintenance regimen may achieve the maximum treatment effect while reducing the cumulative neurotoxicity of oxaliplatin. This study aimed to compare the survival of patients with advanced GC between capecitabine maintenance and observation after 1st line XELOX chemotherapy. Materials and Methods: Sixty-three patients treated with six cycles of XELOX for advanced GC in six hospitals of the Catholic University of Korea were randomized 1:1 to receive capecitabine maintenance or observation. The primary endpoint was progression-free survival (PFS), analyzed using a two-sided log-rank test stratified at a 5% significance level. Results: Between 2015 and 2020, 32 and 31 patients were randomized into the maintenance and observation groups, respectively. After randomization, the median number of capecitabine maintenance cycles was 6. The PFS was significantly higher in the maintenance group than the observation group (6.3 vs. 4.1 months, P=0.010). Overall survival was not significantly different between the 2 groups (18.2 vs. 16.5 months, P=0.624). Toxicities, such as hand-foot syndrome, were reported in some maintenance group patients. Maintenance treatment was a significant factor associated with PFS in multivariate analysis (hazard ratio, 0.472; 95% confidence interval, 0.250-0.890; P=0.020). Conclusions: After 6 cycles of XELOX chemotherapy, capecitabine maintenance significantly prolonged PFS compared with observation, and toxicity was manageable. Maintenance treatment was a significant prognostic factor associated with PFS.

Evaluation for applicability of river depth measurement method depending on vegetation effect using drone-based spatial-temporal hyperspectral image (드론기반 시공간 초분광영상을 활용한 식생유무에 따른 하천 수심산정 기법 적용성 검토)

  • Gwon, Yeonghwa;Kim, Dongsu;You, Hojun
    • Journal of Korea Water Resources Association
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    • v.56 no.4
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    • pp.235-243
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    • 2023
  • Due to the revision of the River Act and the enactment of the Act on the Investigation, Planning, and Management of Water Resources, a regular bed change survey has become mandatory and a system is being prepared such that local governments can manage water resources in a planned manner. Since the topography of a bed cannot be measured directly, it is indirectly measured via contact-type depth measurements such as level survey or using an echo sounder, which features a low spatial resolution and does not allow continuous surveying owing to constraints in data acquisition. Therefore, a depth measurement method using remote sensing-LiDAR or hyperspectral imaging-has recently been developed, which allows a wider area survey than the contact-type method as it acquires hyperspectral images from a lightweight hyperspectral sensor mounted on a frequently operating drone and by applying the optimal bandwidth ratio search algorithm to estimate the depth. In the existing hyperspectral remote sensing technique, specific physical quantities are analyzed after matching the hyperspectral image acquired by the drone's path to the image of a surface unit. Previous studies focus primarily on the application of this technology to measure the bathymetry of sandy rivers, whereas bed materials are rarely evaluated. In this study, the existing hyperspectral image-based water depth estimation technique is applied to rivers with vegetation, whereas spatio-temporal hyperspectral imaging and cross-sectional hyperspectral imaging are performed for two cases in the same area before and after vegetation is removed. The result shows that the water depth estimation in the absence of vegetation is more accurate, and in the presence of vegetation, the water depth is estimated by recognizing the height of vegetation as the bottom. In addition, highly accurate water depth estimation is achieved not only in conventional cross-sectional hyperspectral imaging, but also in spatio-temporal hyperspectral imaging. As such, the possibility of monitoring bed fluctuations (water depth fluctuation) using spatio-temporal hyperspectral imaging is confirmed.

Effect of Restriction of Vitamin A and D on Carcass Characteristics in Hanwoo Steers (비타민 A와 D의 공급제한이 거세 한우의 육질등급에 미치는 영향)

  • Kim, W.Y.;Park, J.K.;Cho, S.Y.;Nam, K.T.;Yeo, J.M.
    • Journal of Practical Agriculture & Fisheries Research
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    • v.18 no.1
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    • pp.13-24
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    • 2016
  • Sixty Hanwoo steers(15 months of age; 409±29.2 kg of BW) were used to evaluate the effects of dietary vitamins A and D restriction on carcass characteristics. Steers were allotted randomly to 1 of 4 treatments: Control(diet supplemented with vitamins A, D and E), -A (diet supplemented with vitamins D and E), -D(diet supplemented with vitamins A and E) and -AD(diet supplemented with vitamin E only). Steers were fed the experimental diet for a period of 8 months(until 23 months of age), and then supplemented with vitamins A and D at 0.05% of the diet(as fed-basis) from 24 to 26 months of age, and at 0.1% of the diet from 27 to 31 months of age(harvesting time). Dietary restriction of vitamins A and D did not affect DM intake, daily gain and feed conversion ratio. But the concentration of serum retinol was significantly(P<0.05) decreased by vitamin A restriction with the lowest concentration being seen at 23 months of age(345.0 ㎍/L and 326.7㎍/L for control and -D treatment versus 169.3 ㎍/L and 175.4 ㎍/L for -A and -AD treatments). The serum concentration of 25(OH)D3 was also decreased significantly(P<0.05) by vitamin D restriction and the lowest concentration was seen at 18 months of age(53.7ng/ml and 61.8ng/ml for control and - A treatment versus 24.0 ng/ml and 24.5 ng/ml for -D and -AD treatments). After the restriction period of vitamins A and D, the concentrations of retinol and 25(OH)D3 for - A, -D and -AD treatments were recovered at those of control. Dietary restriction of vitamins A and D did not affect carcass weight, backfat thickness, ribeye area, quality grade and yield grade. But marbling score was significantly increased by vitamin A restriction compared with control(6.73, 6.87 and 5.73 for -A, -AD and control, respectively). The results of the present study suggested that dietary vitamin A restriction could improve marbling score in Hanwoo steers.

Effects of Moisture Absorbent Application Timing on Performance, Blood Cell Characteristics and Footpad Dermatitis in Broiler Houses (육계 계사 내 수분흡수제 도포 시기가 생산성, 혈구 성상 및 발바닥피부염에 미치는 영향)

  • Eui-Chul Hong;Jin-Joo Jeon;Hee-Jin Kim
    • Korean Journal of Poultry Science
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    • v.50 no.3
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    • pp.125-132
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    • 2023
  • This study was conducted to investigate the effect of moisture absorbent (MA) application timing for litter management on broiler performance, blood cell characteristics, litter moisture content, incidence of footpad dermatitis (FPD), and economics analysis. Treatment include untreated control (NC), 3-week-old litter treatment (PC), 0-week-old (W1), 0 and 3-week-old (W2), 3-week-old (W3) application of moisture absorbent. Six hundred eighty broilers (1-day-old, 42.0±0.24 g) were divided into 5 treatments (4 replications per treatment, 34 birds per replication) and raised for 5 weeks in a floor (2 m2 per pen). There was no significant difference among treatments in performance, blood cell characteristics, and H/L ratio according to the application period of litter and moisture absorbent. The litter moisture content and the FPD score were significantly decreased in the litter and moisture absorbent treatments at the age of 5 weeks (P<0.05). The FPD score of broilers was lowest in PC treatment compared to NC treatment (P<0.05). The incidence of FPD was lower in PC and W3 treatments compared to other treatments, and that was the highest in NC treatment. As a result of analyzing the economic feasibility, the highest expenditure occurred in PC treatment, and the lowest expenditure occurred in W3 treatment. Income was the highest in W3 treatment, and lowest in NC treatment. The profit was 185,859 won (1,367 won/unit), the highest in the W3 treatment. In conclusion, when MA was applied to the litter of broiler house at the age of 3 weeks, the litter moisture content and FPD were improved.

Effects of 1-methylcyclopropene (1-MCP) treatment on the maintenance of fruit quality of RubyS apples during cold storage ('루비에스' 사과의 저온저장 중 과실품질 유지를 위한 1-methylcyclopropene 처리 효과)

  • Jingi Yoo;Hwajong Yoo;Nay Myo Win;Hee-Young Jung;Young-Je Cho;In-Kyu Kang
    • Food Science and Preservation
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    • v.30 no.1
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    • pp.78-87
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    • 2023
  • This study was conducted to evaluate the effect of different 1-methylcyclopropene (1-MCP) concentrations on fruit quality of small-sized RubyS apples during cold storage. After harvesting, the fruits were treated with 1-MCP at 0.5 or 1 µL/L concentrations and, subsequently, stored at 0℃ for 6 months. After 6 months, the flesh firmness of untreated fruits, which was 85.4 N at harvest, had gradually decreased to 46.5 N; however, that of 1-MCP-treated fruits was maintained at 59.1 and 59.5 N. Titratable acidity (TA) of untreated fruits had also decreased from 0.42 to 0.24%, whereas that of 1-MCP-treated fruits was maintained at 0.26 and 0.27%. Soluble solids content (SSC) did not differ in all fruits. However, the 1-MCP-treated fruits had lower levels of SSC/TA ratio than untreated fruits. Moreover, after 6 months, the ethylene production had increased to 47.0 µL/kg/h in the untreated fruits, whereas 1-MCP blocked the ethylene production at 1.4 and 1.7 µL/kg/h. The weight loss and peel color variables remained unaffected by 1-MCP treatments. Thus, these results indicated that, for RubyS apples, the storability was only 2 months at 0℃ without treatment, which can be extended to 6 months with 1-MCP treatments. The application of 1-MCP at 0.5 µL/L concentration is effectively and economically sufficient to maintain the quality of RubyS apples.

Teleseismic Travel Time Tomography for the Mantle Velocity Structure Beneath the Melanesian Region (원거리 지진 주시 토모그래피를 이용한 멜라네시아 지역의 맨틀 속도 구조 연구)

  • Jae-Hyung Lee;Sung-Joon Chang
    • Economic and Environmental Geology
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    • v.57 no.1
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    • pp.1-15
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    • 2024
  • The Melanesian region in the western Pacific is dominated by complex plate tectonics, with the largest oceanic plateau, the OntongJava plateau, and a hotspot, the Caroline Islands. To better understand the complex geodynamics of the region, we estimate P- and S-velocity models and 𝛿 (VP/VS) model by using relative teleseismic travel times measured at seismometers on land and the seafloor. Our results show high-velocity anomalies in the subduction zones of the Melanesian region to a depth of about 400 km, which is thought to be subducting Solomon Sea, Bismarck, and Australian plates along plate boundaries. Along subduction zones, positive 𝛿 (VP/VS) anomalies are found, which may be caused by partial melting due to dehydration. A broad high-velocity anomaly is observed at 600 km depth below the Ontong-Java plateau, with a negative 𝛿 (VP/VS) anomaly. This is thought to be a viscous and dry remnant of the Pacific plate that subducted at 45-25 Ma, with a low volume of fluids due to dehydration for a long period in the mantle transition zone. Beneath the Caroline Islands, a strong low-velocity anomaly is obseved to a depth of 800 km and appears to be connected to the underside of the remnant Pacific plate in the mantle transition zone. This suggests that the mantle plume originating in the lower mantle has been redirected due to the interaction with the remnant Pacific plate and has reached its current location. The mantle plume also has a positive 𝛿 (VP/VS) anomaly, which is thought to be due to the influence of embedded fluids or partial melting. A high-velocity anomaly, interpreted as an effect of the thick lithosphere beneath the Ontong-Java plateau, is observed down to 300 km depth with a negative 𝛿 (VP/VS) anomaly, which likely indicate that little fluid remains in the melt residue accumulated in the lithosphere.

Impact of the Utilization Gap of the Community-Based Smoking Cessation Programs on the Attempts for Quitting Smoking between Wonju and Chuncheon Citizen (원주시민과 춘천시민의 지역사회 내 금연프로그램 이용 격차가 금연 시도에 미치는 영향)

  • Kyung-Yi Do;Kwang-Soo Lee;Jae-Hwan Oh;Ji-Hae Park;Yun-Ji Jeong;Je-Gu Kang;Sun-Young Yoon;Chun-Bae Kim
    • Journal of agricultural medicine and community health
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    • v.49 no.1
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    • pp.37-49
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    • 2024
  • Objectives: This study aimed to explore whether there are differences in smoking status between two regions of Wonju-City and Chuncheon-City, Gangwon State, and to determine whether the experience of smoking cessation programs in the region affects quit attempts. Methods: The study design was a cross-sectional study in which adults aged 19 and older living in two cities were surveyed using a pre-developed mobile app to investigate social capital for smoking cessation, and a total of 600 citizens were participated, including 310 in Wonju-City and 290 in Chuncheon-City. The statistical analysis was conducted using chi-square test and logistic regression analysis. Results: Wonju-City had a higher prevalence of current smoking than Chuncheon-City. Among smoking cessation programs operated by local public health centers, Wonju-City had a lower odds ratio for experience with smoking cessation education than Chuncheon-City (OR=0.52, 95% CI=0.33 to 0.81). When examining the effect of smoking cessation program experience on quit attempts, in Wonju-City, citizens who had completed smoking cessation education and used a smoking cessation clinic were more likely to attempt to quit than those who had not (OR=2.31 and OR=2.29, respectively). In Chuncheon-City, citizens who were aware of smoking cessation support services were 2.26 times more likely to attempt to quit smoking than those who were not, but statistical significance was not reached due to the small sample size. Conclusion: Therefore, healthcare organizations in both regions should develop more practical intervention strategies to increase smokers' quit attempts, reduce smoking rates in the community, and address regional disparities.

Effects of the Type of Exchanged Ions and Carbon Precursors on Methane Adsorption Behavior in Zeolite Templated Carbons Synthesized Using Various Ion-Exchanged Faujasite Zeolites (이온교환된 Faujasite 제올라이트를 이용한 제올라이트 주형 탄소체 합성 시 이온 교환 금속과 탄소 전구체가 메탄 흡착 거동에 미치는 영향)

  • Ki Jun Kim;Churl-hee Cho;Dong-Woo Cho
    • Clean Technology
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    • v.30 no.2
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    • pp.123-133
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    • 2024
  • Zeolite template carbon (ZTC) was synthesized as an adsorbent to remove low-concentration CH4 from the atmosphere. The synthesis of ZTC was performed using CH4 and C2H2 as carbon precursors and their impact on adsorption was investigated. ZTC was also synthesized using Y zeolite ion-exchanged with CaCl2 and LiCl as templates to investigate the effect of using metals in ion exchange. The comparison of the carbon precursors revealed that C2H2 had a higher carbon yield than CH4. The synthesized ZTC exhibited developed micropores due to carbon deposition deep inside the micropores of the zeolite template. The kinetic diameter of C2H2 (0.33 nm) is smaller than that of CH4 (0.38 nm), which allowed for its deposition. The study compared metal precursors used for ion exchange and confirmed that the CaCl2-based ZTC developed more micropores compared to the LiCl-based ZTC. The ion-exchanged Ca inhibited pore blocking by the carbon precursor, allowing it to enter the pores. The ability of synthesized ZTC to adsorb N2 and CH4 at 298 K was investigated. The results showed that CH4 had a higher overall adsorption amount than N2. The sample synthesized using C2H2 and CaY exhibited the highest N2 and CH4 adsorption capacity. However, the sample synthesized with CH4 had the highest CH4/N2 gas uptake ratio, which is a crucial factor in designing an adsorption process. The observed difference was likely caused by the underdevelopment of ultrafine pores that are associated with N2 adsorption. This resulted in a reduction of N2 adsorption, leading to an increase in CH4/N2 separation.

The Effect of Mutual Trust on Relational Performance in Supplier-Buyer Relationships for Business Services Transactions (재상업복무교역중적매매관계중상호신임대관계적효적영향(在商业服务交易中的买卖关系中相互信任对关系绩效的影响))

  • Noh, Jeon-Pyo
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.4
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    • pp.32-43
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    • 2009
  • Trust has been studied extensively in psychology, economics, and sociology, and its importance has been emphasized not only in marketing, but also in business disciplines in general. Unlike past relationships between suppliers and buyers, which take considerable advantage of private networks and may involve unethical business practices, partnerships between suppliers and buyers are at the core of success for industrial marketing amid intense global competition in the 21st century. A high level of mutual cooperation occurs through an exchange relationship based on trust, which brings long-term benefits, competitive enhancements, and transaction cost reductions, among other benefits, for both buyers and suppliers. In spite of the important role of trust, existing studies in buy-supply situations overlook the role of trust and do not systematically analyze the effect of trust on relational performance. Consequently, an in-depth study that determines the relation of trust to the relational performance between buyers and suppliers of business services is absolutely needed. Business services in this study, which include those supporting the manufacturing industry, are drawing attention as the economic growth engine for the next generation. The Korean government has selected business services as a strategic area for the development of manufacturing sectors. Since the demands for opening business services markets are becoming fiercer, the competitiveness of the business service industry must be promoted now more than ever. The purpose of this study is to investigate the effect of the mutual trust between buyers and suppliers on relational performance. Specifically, this study proposed a theoretical model of trust-relational performance in the transactions of business services and empirically tested the hypotheses delineated from the framework. The study suggests strategic implications based on research findings. Empirical data were collected via multiple methods, including via telephone, mail, and in-person interviews. Sample companies were knowledge-based companies supplying and purchasing business services in Korea. The present study collected data on a dyadic basis. Each pair of sample companies includes a buying company and its corresponding supplying company. Mutual trust was traced for each pair of companies. This study proposes a model of trust-relational performance of buying-supplying for business services. The model consists of trust and its antecedents and consequences. The trust of buyers is classified into trust toward the supplying company and trust toward salespersons. Viewing trust both at the individual level and the organizational level is based on the research of Doney and Cannon (1997). Normally, buyers are the subject of trust, but this study supposes that suppliers are the subjects. Hence, it uniquely focused on the bilateral perspective of perceived risk. In other words, suppliers, like buyers, are the subject of trust since transactions are normally bilateral. From this point of view, suppliers' trust in buyers is as important as buyers' trust in suppliers. The suppliers' trust is influenced by the extent to which it trusts the buying companies and the buyers. This classification of trust using an individual level and an organization level is based on the suggestion of Doney and Cannon (1997). Trust affects the process of supplier selection, which works in a bilateral manner. Suppliers are actively involved in the supplier selection process, working very closely with buyers. In addition, the process is affected by the extent to which each party trusts its partners. The selection process consists of certain steps: recognition, information search, supplier selection, and performance evaluation. As a result of the process, both buyers and suppliers evaluate the performance and take corrective actions on the basis of such outcomes as tangible, intangible, and/or side effects. The measurement of trust used for the present study was developed on the basis of the studies of Mayer, Davis and Schoorman (1995) and Mayer and Davis (1999). Based on their recommendations, the three dimensions of trust used for the study include ability, benevolence, and integrity. The original questions were adjusted to the context of the transactions of business services. For example, a question such as "He/she has professional capabilities" has been changed to "The salesperson showed professional capabilities while we talked about our products." The measurement used for this study differs from those used in previous studies (Rotter 1967; Sullivan and Peterson 1982; Dwyer and Oh 1987). The measurements of the antecedents and consequences of trust used for this study were developed on the basis of Doney and Cannon (1997). The original questions were adjusted to the context of transactions in business services. In particular, questions were developed for both buyers and suppliers to address the following factors: reputation (integrity, customer care, good-will), market standing (company size, market share, positioning in the industry), willingness to customize (product, process, delivery), information sharing (proprietary information, private information), willingness to maintain relationships, perceived professionalism, authority empowerment, buyer-seller similarity, and contact frequency. As a consequential variable of trust, relational performance was measured. Relational performance is classified into tangible effects, intangible effects, and side effects. Tangible effects include financial performance; intangible effects include improvements in relations, network developing, and internal employee satisfaction; side effects include those not included either in the tangible or intangible effects. Three hundred fifty pairs of companies were contacted, and one hundred five pairs of companies responded. After deleting five company pairs because of incomplete responses, one hundred five pairs of companies were used for data analysis. The response ratio of the companies used for data analysis is 30% (105/350), which is above the average response ratio in industrial marketing research. As for the characteristics of the respondent companies, the majority of the companies operate service businesses for both buyers (85.4%) and suppliers (81.8%). The majority of buyers (76%) deal with consumer goods, while the majority of suppliers (70%) deal with industrial goods. This may imply that buyers process the incoming material, parts, and components to produce the finished consumer goods. As indicated by their report of the length of acquaintance with their partners, suppliers appear to have longer business relationships than do buyers. Hypothesis 1 tested the effects of buyer-supplier characteristics on trust. The salesperson's professionalism (t=2.070, p<0.05) and authority empowerment (t=2.328, p<0.05) positively affected buyers' trust toward suppliers. On the other hand, authority empowerment (t=2.192, p<0.05) positively affected supplier trust toward buyers. For both buyers and suppliers, the degree of authority empowerment plays a crucial role in the maintenance of their trust in each other. Hypothesis 2 tested the effects of buyerseller relational characteristics on trust. Buyers tend to trust suppliers, as suppliers make every effort to contact buyers (t=2.212, p<0.05). This tendency has also been shown to be much stronger for suppliers (t=2.591, p<0.01). On the other hand suppliers trust buyers because suppliers perceive buyers as being similar to themselves (t=2.702, p<0.01). This finding confirmed the results of Crosby, Evans, and Cowles (1990), which reported that suppliers and buyers build relationships through regular meetings, either for business or personal matters. Hypothesis 3 tested the effects of trust on perceived risk. It has been found that for both suppliers and buyers the lower is the trust, the higher is the perceived risk (t=-6.621, p<0.01 for buyers; t=-2.437, p<0.05). Interestingly, this tendency has been shown to be much stronger for buyers than for suppliers. One possible explanation for this higher level of perceived risk is that buyers normally perceive higher risks than do suppliers in transactions involving business services. For this reason, it is necessary for suppliers to implement risk reduction strategies for buyers. Hypothesis 4 tested the effects of trust on information searching. It has been found that for both suppliers and buyers, contrary to expectation, trust depends on their partner's reputation (t=2.929, p<0.01 for buyers; t=2.711, p<0.05 for suppliers). This finding shows that suppliers with good reputations tend to be trusted. Prior experience did not show any significant relationship with trust for either buyers or suppliers. Hypothesis 5 tested the effects of trust on supplier/buyer selection. Unlike buyers, suppliers tend to trust buyers when they think that previous transactions with buyers were important (t=2.913 p<0.01). However, this study did not show any significant relationship between source loyalty and the trust of buyers in suppliers. Hypothesis 6 tested the effects of trust on relational performances. For buyers and suppliers, financial performance reportedly improved when they trusted their partners (t=2.301, p<0.05 for buyers; t=3.692, p<0.01 for suppliers). It is interesting that this tendency was much stronger for suppliers than it was for buyers. Similarly, competitiveness was reported to improve when buyers and suppliers trusted their partners (t=3.563, p<0.01 for buyers; t=3.042, p<0.01 for suppliers). For suppliers, efficiency and productivity were reportedly improved when they trusted buyers (t=2.673, p<0.01). Other performance indices showed insignificant relationships with trust. The findings of this study have some strategic implications. First and most importantly, trust-based transactions are beneficial for both suppliers and buyers. As verified in the study, financial performance can be improved through efforts to build and maintain mutual trust. Similarly, competitiveness can be increased through the same kinds of effort. Second, trust-based transactions can facilitate the reduction of perceived risks inherent in the purchasing situation. This finding has implications for both suppliers and buyers. It is generally believed that buyers perceive higher risks in a highly involved purchasing situation. To reduce risks, previous studies have recommended that suppliers devise risk-reducing tactics. Moving beyond these recommendations, the present study uniquely focused on the bilateral perspective of perceived risk. In other words, suppliers are also susceptible to perceived risks, especially when they supply services that require very technical and sophisticated manipulations and maintenance. Consequently, buyers and suppliers must solve problems together in close collaboration. Hence, mutual trust plays a crucial role in the problem-solving process. Third, as found in this study, the more authority a salesperson has, the more he or she can be trusted. This finding is very important with regard to tactics. Building trust is a long-term assignment; however, when mutual trust has not been developed, suppliers can overcome the problems they encounter by empowering a salesperson with the authority to make certain decisions. This finding applies to suppliers as well.

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Use of Noninvasive Mechanical Ventilation in Acute Hypercapnic versus Hypoxic Respiratory Failure (급성 환기부전과 산소화부전에서 비침습적 환기법의 비교)

  • Lee, Sung Soon;Lim, Chae-Man;Kim, Baek-Nam;Koh, Younsuck;Park, Pyung Hwan;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.987-996
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    • 1996
  • Background : We prospectively evaluated the applicability and effect of noninvasive ventilation (NIV) in acute respiratory failure and tried to find out the parameters that could predict successful application of NIV. Methods : Twenty-six out of 106 patients with either acute ventilatory failure (VF: $PaCO_2$ > 43 mm Hg with pH < 7.35) or oxygenation failure (OF: $PaO_2/AO_2$ < 300 mm Hg with $pH{\geq}7.35$) requiring mechanical ventilation were managed by NIV (CPAP + pressure suppon, or BiPAP) with face mask. Eleven out of 19 cases with VF (57.9%) (M : F=7 : $55.4{\pm}14.6$ yrs) and 15 out of 87 cases with OF (17.2%) (M : F=12 : 3, $50.6{\pm}15.6$ yrs) were s uilable for NIY. Respiratory rates, arterial blood gases and success rate of NIV were analyzed in each group. Results: 81.8% (9/11) of YF and 40% (6/15) of OF were successfully managed on NIV and were weruled from mechanical ventilator without resorting to endotracheal intubation. Complications were noted in 2 cases (nasal skin necrosis 1, gaseous gastric distension 1). In NIV for ventilatory failure, the respiration rate was significantly decreased at 12 hour of NIV ($34{\pm}9$ /min pre-NIV, $26{\pm}6$ /min at 12 hour of NIV, p=0.045), while $PaCO_2$ ($87.3{\pm}20.6$ mm Hg pre-NIV, $81.2{\pm}9.1$ mm Hg at 24 hour of NIV) and pH ($7.26{\pm}0.04$, $7.32{\pm}0.02$, respectively, p <0.05) were both significantly decreased at 24 hour of NIV In NIV for oxygenation failure, $PaCO_2$ were not different between the successful and the failed cases at pre-NIV and till 12 hours after NIV. The $PaO_2/FIO_2$ ratio, however, significantly improved at 0.5 hour of NIV in successful cases and were maintained at around 200 mm Hg (n=6 : at baseline, 0.5h, 6h, 12h : $120.0{\pm}19.6$, $218.9{\pm}98.3$, $191.3{\pm}55.2$, $232.8{\pm}17.6$ mm Hg, respectively, p=0.0211), but it did not rise in the failed cases (n=9 : $127.9{\pm}63.0$, $116.8{\pm}24.4$, $100.6{\pm}34.6$, $129.8{\pm}50.3$ mm Hg, respectively, p=0.5319). Conclusion : From the above results we conclude that NIV is effective for hypercapnic respiratory failure and its success was heralded by reduction of respiration rale before the reduction in $PaCO_2$ level. In hypoxic respiratory failure, NIV is much less effective, and the immediate improvement of $PaO_2/FIO_2$ ratio at 0.5h after application is thought to be a predictor of successful NIV.

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