• Title/Summary/Keyword: Effective discharge

Search Result 1,010, Processing Time 0.025 seconds

Impact of Device Evolution in Transcatheter Closure of Patent Ductus Arteriosus Using Duct-Occlud Coils : Comparison of Mid-term Results (경피적 동맥관 폐쇄술에 사용된 Duct-Occlud Coil의 종류에 따른 중-단기 결과의 비교)

  • Kim, Myung Kwan;Han, Dong Ki;Choi, Jae Young;Kim, Yuria;Yoo, Byung Won;Choi, Deok Young;Sul, Jun Hee;Lee, Sung Kue
    • Clinical and Experimental Pediatrics
    • /
    • v.48 no.2
    • /
    • pp.158-164
    • /
    • 2005
  • Purpose : We reviewed the therapeutic results of various Duct-Occlud coils(pfm AG, $K{\ddot{o}}ln$, Germany) to evaluate the efficacy of the most-recently modified Duct-Occlud coil(Nit-Occlud) in the transcatheter closure of patent ductus arteriosus(PDA), including large defects more than 4 mm in diameter. Methods : Two hundred and five patients who underwent percutaneous PDA occlusion using Duct-Occlud devices from March 1996 to December 2003 were enrolled and four types of Duct-Occlud [Standard(S), Reinforced(R), Reinforced reverse cone(RR) and Nit-Occlud(N)] were used in this study. The patients were followed up by echocardiogram and physical examination before discharge, one month, six months and 12 months after the procedure. Results : The rate of residual shunt according to the type of Duct-Occlud were as follows : S-54%, R-72%, RR-50%, N-14%(P<0.05 compared with other devices) at one month, S-25%, R-44%, RR-37%, N-0%(P<0.05 compared with other devices) at six months, S-8%, R-8%, RR-4%, N-0%(P<0.05 compared with S and R) at 12 months and later. Nit-Occlud coil showed the complete occlusion of PDA after six months of follow-up, even in 12 patients with relatively large PDA(>4 mm). Conclusion : The transcatheter closure of PDA using Duct-Occlud was an effective treatment and our study revealed that a Nit-Occlud coil which showed higher rate of occlusion even in PDA with large diameters over than 4 mm, was a more effective modality compared to previous devices.

Effect of Synagis (palivizumab) prophylaxis on readmission due to respiratory syncytial virus in very low birth weight infants (극소 저체중 출생아에서 Synagis (palivizumab) 접종이 respiratory syncytial virus 감염으로 인한 재입원에 미치는 영향)

  • Park, Soo Kyoung;Jung, Yu Jin;Yoo, Hye Soo;Ahn, So Yoon;Seo, Hyun Joo;Choi, Seo Hui;Kim, Myo Jing;Jeon, Ga Won;Koo, Soo Hyun;Lee, Kyung-Hoon;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
    • /
    • v.53 no.3
    • /
    • pp.358-364
    • /
    • 2010
  • Purpose : The aim of this study was to determine the efficacy of $Synagis^{(R)}$ (palivizumab) in reducing the respiratory syncytial virus (RSV) readmission rate in very low birth weight infants (VLBWI ) and the subgroup that showed the most effective vaccination. Methods : We enrolled 350 VLBWI who had been discharged alive from the neonatal intensive care unit of Samsung Medical Center from January 2005 to December 2007 and were followed up for at least one year. A retrospective study based on medical records was performed for a period of one year after discharge. RSV readmission rate was investigated according to BPD (bronchopulmonary dysplasia, requiring oxygen at postnatal day 28) and $Synagis^{(R)}$ prophylaxis. We categorized the subgroups by the severity of BPD gestational age, and birth weight and compared the RSV readmission rates between subgroups. Results : Eleven VLBWI were readmitted. $Synagis^{(R)}$ prophylaxis resulted in a 86% reduction in the rate of readmission due to RSV infection (prophylaxis group, 0.7% and no prophylaxis group, 5.0%; P =0.02). Readmission rate in BPD patients was also reduced in the prophylaxis group (0.7% in the prophylaxis group vs. 5.2% in the no prophylaxis group, P =0.03). The readmission rate in patients without BPD was reduced in the prophylaxis group (0% in the prophylaxis group vs. 4.9% in the no prophylaxis group, P =1.00), but this was not statistically significant.Conclusion : $Synagis^{(R)}$ prophylaxis was effective at reducing RSV readmission in VLBWI. Its efficacy was verified irrespective of BPD, gestational age, or birth weight.

Recovery of $SF_6$ gas from Gaseous Mixture ($SF_6/N_2/O_2/CF_4$) through Polymeric Membranes (고분자 분리막을 이용한 혼합가스($SF_6/N_2/O_2/CF_4$)로부터 $SF_6$의 회수)

  • Lee, Hyun-Jung;Lee, Min-Woo;Lee, Hyun-Kyung;Choi, Ho-Sang;Lee, Sang-Hyup
    • Membrane Journal
    • /
    • v.21 no.1
    • /
    • pp.22-29
    • /
    • 2011
  • During the maintenance, repair and replacement process of circuit breaker, $SF_6$ reacted with input air in arc discharge, which led to the production of by-product gases (eg, $N_2$, $O_2$, $CF_4$, $SO_2$, $H_2O$, HF, $SOF_2$, $CuF_2$, $WO_3$). Among these various by-product gases, $N_2$, $O_2$, $CF_4$ is major component. Therefore, the effective separation process is necessary to recycle the $SF_6$ gas from the mixture gas containing $N_2$, $O_2$, $CF_4$. In this study, the membrane separation process was applied to recycle the $SF_6$ gas from the mixture gas containing $N_2$, $O_2$, $CF_4$. The concentration of $SF_6$ gas in gas produced from the electric power industry is over than 90 vol%. Therefore, we made the simulated gas containing $N_2$, $O_2$, $CF_4$, $SF_6$ which the concentration of $SF_6$ gas is minimum 90 vol%. From the results of membrane separation process of $SF_6$ gas from $N_2$, $O_2$, $CF_4$ $SF_6$ mixture gases, PSF membrane shown the highest recovery efficiency 92.7%, in $25^{\circ}C$ and 150 cc/min of retentate flow rate. On the other hand, PC membrane shown the highest recovery efficiency 74.8%, in $45^{\circ}C$ and 150 cc/min of retentate flow rate. Also, the highest rejection rate of $N_2$, $O_2$, $CF_4$ is 80, 74 and 58.9% seperately in the same operation condition of highest recovery efficiency. From the results, we supposed the membrane separation process as the effective $SF_6$ separation and recycle process from the mixture gas containing $N_2$, $O_2$, $CF_4$, $SF_6$.

A Comparative Study on Hydraulic Jump and Specific Energy Losses at Downstream According to the Weir Discharge Types (보 유출형태에 따른 하류부 도수 및 비에너지 손실에 관한 비교 연구)

  • Park, Hyo-Seon;Yoon, Geun-Ho;Koo, Bon-Jin;Choi, Gye-Woon
    • Journal of Wetlands Research
    • /
    • v.15 no.1
    • /
    • pp.149-157
    • /
    • 2013
  • The weirs built so far are mainly overflow type weirs overflowing to the upstream. Main advantages of overflow type weirs are, effective water resources management and easy design, construction and maintenance due to many accumulated studies. However, due to the special feature of the overflow type weir where water overflows through the upstream of the weir, the silt coming from the upstream is not discharged to the downstream of the weir. This increases the river bed and reduces the reservoir capacity, and as a result, the weir loses its function. A underflow type weir with a water gate has been implemented in order to solve such sediment deposit and weir maintenance problems. However due to the design problem of recently constructed underflow type weirs, the river bed of the downstream of a weir has been scoured. And this leds to a structural problem. In this study, the flow characteristics of overflow type weirs and underflow type weir, hydraulic jump length analysis depending on change of water depth and the amount of specific energy loss generated per unit length depending on a weir type have been compared and analyzed, for the effective design and management of the weirs. The experiment results show that, when identical upstream conditions of underflow type weir and an overflow type weir were maintained, the hydraulic jump length was up to twice longer with Fr(Froude number) 3.5 of the hydraulic jump length at the underflow type weir, and the hydraulic jump length gradually decreased as the downstream water depth increased. The comparative analysis result of the amount of specific energy loss generated per unit length showed that the amount of energy loss per unit length was twice higher for an overlfow type weir than a underflow type weir. Therefore, in case of a underflow type facility, an additional energy reduction facility is determined to be necessary for safety of water construction structures.

Efficacy of Self-manipulation Technique in the Treatment of Patients with Anterior Disc Displacement without Reduction (비정복성 관절원판 전방변위 환자의 치료에 있어서 자가 수조작술의 효과에 대한 연구)

  • Kim, Ju-Sik;Lee, Chae-Hoon;Kim, Young-Ku
    • Journal of Oral Medicine and Pain
    • /
    • v.32 no.4
    • /
    • pp.441-447
    • /
    • 2007
  • Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.

The SOFA Score to Evaluate Organ Failure and Prognosis in the Intensive Care Unit Patients (중환자실에 입원한 환자의 장기부전 및 예후 평가를 위한 SOFA 점수체계의 의의)

  • Kim, Su Ho;Lee, Myung Goo;Park, Sang Myeon;Park, Young Bum;Jang, Seung Hun;Kim, Cheol Hong;Jeon, Man Jo;Shin, Tae Rim;Eom, Kwang Seok;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Seung-Joon
    • Tuberculosis and Respiratory Diseases
    • /
    • v.57 no.4
    • /
    • pp.329-335
    • /
    • 2004
  • Background : The Sequential Organ Failure Assessment (SOFA) score can help to assess organ failure over time and is useful to evaluate morbidity. The aim of this study is to evaluate the performance of SOFA score as a descriptor of multiple organ failure in critically ill patients in a local unit hospital, and to compare with APACHE III scoring system. Methods : This study was carried out prospectively. A total of ninety one patients were included who admitted to the medical intensive care unit (ICU) in Chuncheon Sacred Heart Hospital from May 1 through June 30, 2000. We excluded patients with a length of stay in the ICU less than 2 days following scheduled procedure, admissions for ECG monitoring, other department and patients transferred to other hospital. The SOFA score and APACHE III score were calculated on admission and then consecutively every 24 hours until ICU discharge. Results : The ICU mortality rate was 20%. The non-survivors had a higher SOFA score within 24 hours after admission. The number of organ failure was associated with increased mortality. The evaluation of a subgroup of 74 patients who stayed in the ICU for at least 48 hours showed that survivors and non-survivors followed a different course. In this subgroup, the total SOFA score increased in 81% of the non-survivors but in only 21% of the survivors. Conversely, the total SOFA score decreased in 48% of the survivors compared with 6% of the non-survivors. The non-survivors also had a higher APACHE III score within 24 hours and there was a correlation between SOFA score and APACHE III score. Conclusion : The SOFA score is a simple, but effective method to assess organ failure and to predict mortality in critically ill patients. Regular and repeated scoring enables patient's condition and clinical course to be monitored and better understood. The SOFA score well correlates with APACHE III score.

Small-Scale Pond Effects on Reducing Pollutants Load from a Paddy Field (논의 양분유출 저감을 위한 저류지 효과)

  • Kim, Min-Kyeong;Kwon, Soon-Ik;Jung, Goo-Bok;Hong, Seong-Chang;Chae, Mi-Jin;Yun, Sun-Gang;So, Kyu-Ho
    • Korean Journal of Environmental Agriculture
    • /
    • v.32 no.4
    • /
    • pp.355-358
    • /
    • 2013
  • BACKGROUND: Water-born pollution loads by agricultural non-point source (NPS) pollution are expected to become intensified due to ongoing precipitation change. Therefore, it is essential to develop a best management practice (BMP) that is suitable to agricultural environments in Korea. This study aimed to develop an environmental-friendly BMP to reduce NPS pollution load by agricultural activities. An eco-friendly way, small drainage pond, was suggested in this study to avoid direct drainage of agricultural runoffs and eventually reduce the amount of pollutants discharged into the surrounding aqua-environment. METHODS AND RESULTS: A small pond ($12m^2$) was constructed at the corner of a rice paddy field ($1,715m^2$) located in Suwon, Korea. Water was allowed to drain only via a small drainage pond. Sampling was repeatedly made at two locations, one from an entrance and the other from an exit of a pond, during the rice cultivation period (May to October, 2012). Generally, sampling was made only when runoff water drained through a pond, such as during and/or after rain (irrigation). The water quality analysis showed that all quality parameters (SS, $COD_{Mn}$, T-N, and T-P) were improved as water passed through the pond. The amount of runoff water was reduced by 96~100%. Suspended solids and COD concentrations was reduced by 79.3% and 45.6%, respectively. In case of T-N and T-P concentrations, the reduction rates were 52.2% and 60.5%, respectively and the amount of T-N and T-P were reduced by 16.3~73.0% and 15.4~70.1%, respectively. CONCLUSION(S): Our data implies that agricultural NPS pollution from rice paddy fields can be effectively managed when an appropriate drainage water management practice is imposed. In this paper, it was suggested that an installation of a small drainage pond can be effective to prevent not only the nutrient loss from rice fields but also pollutant discharge to surrounding water environments.

Effect of Breast-feeding Education and Follow-up care on the Breast-feeding Rate and the Breast-feeding Method - Focused on Home Visit and Phone Counselling - (모유수유교육과 추후간호방법이 산모의 모유수유실천율과 모유수유방법에 미치는 효과 - 가정방문과 전화상담을 중심으로 -)

  • Park, Sook-Hee;Koh, Hyo-Jung
    • Women's Health Nursing
    • /
    • v.7 no.1
    • /
    • pp.30-43
    • /
    • 2001
  • This was a pre-experimental study to confirm the breast-feeding ability and effect of follow up care on the breast-feeding rate and the breast-feeding method by the mother-infant breast-feeding assessment tool for the mothers who got the breast-feeding education. The subjects were 46 mothers who experienced normal delivery of infants at a college hospital in K-city, Kyungsangbuk-do, from July 1 to October 21, 2000. The instrument for data obtainment were The Mother-Infant Breast-Feeding Assessment Tool of Johnson et al. (1999), and The Breast- Feeding Method Measurement Tool of Jeong, Geum-hee(1997). This instrument was reliable, showing Cronbach $\alpha$.751. This study classified them into 3 groups: at high risk for breast-feeding failure, at risk for breast-feeding problems, and at low risk for breast-feeding failure by the mother-infant breast-feeding assessment tool on the day of discharge from the hospital after delivering individual breast-feeding education to the subjects. This study investigated the breast-feeding rate and the breast-feeding method through mail questionnaire at the four week after childbirth, and through the phone counselling and the home visit for follow up care at the first week and the second week after childbirth. The sixth week after childbirth, this study investigated the breast-feeding rate by phone. The data analyzed the hypothesizes by $x^2$-test, paired t-test, ANOVA, Wilcoxon signed rank test, Wilcoxon rank sum test and trend analysis using SPSS/PC+ WIN 10.0 program. The results were as follows : 1) Hypothesis 1-1, "there won't be any difference the breast-feeding rate of a group at risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t= -1.501, p=.270). Hypothesis 1-2, "there won't be any difference the breast-feeding rate of group at low risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t=-1.732, p=.225). 2) Hypothesis 2-1, "there won't be any difference between the breast-feeding method of group at risk for breast-feeding failure for four weeks after childbirth and just after childbirth” was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-7.267, p=.000). Hypothesis 2-2, "there won't be any difference between the breast-feeding method of the group at low risk for breast-feeding failure for four weeks after childbirth and just after childbirth" was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-2.501, p=.012). 3)The 3rd hypothesis, "there won't be any difference between breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure at the 4th week after childbirth and just after childbirth" didn't show any difference between the breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure in the advance test(t=-1.521, p=.130) but there was difference between them in post test (t=-2.012, p=.044). As a result, the 3rd hypothesis was supported by pre test, but it was rejected by post test. In conclusion, this study confirmed breast- feeding education and follow up care just after childbirth were effective for the breast-feeding rate and method. Accordingly, it is proposed that successful nursing intervention of breast-feeding to be necessary by continuously providing follow up care through the mother-infant breast-feeding assessment tool as well as to execute individual breast-feeding education to mothers just after childbirth.

  • PDF

Perception and Satisfaction on Nutrition Counseling Service for Patients Consuming a Therapeutic Diet at Hospitals in Busan (부산지역 일부병원 치료식 섭취 환자의 영양상담에 대한 인식 및 만족도)

  • Yi, Jeong-Ryeh;Son, Eun-Joo;Lyu, Eun-Soon
    • Journal of the Korean Society of Food Science and Nutrition
    • /
    • v.39 no.9
    • /
    • pp.1305-1312
    • /
    • 2010
  • The purpose of this study was to investigate the perception and satisfaction on the nutrition counseling service for patients consuming a therapeutic diet at hospitals in Busan. The subjects were 153 inpatients at five hospitals with over 400 beds each. The research was performed through the interviewing process using questionnaires conducted from January to February, 2008. In a total of 88 patients, 57.5% had experienced nutrition counseling and were through the motives of counseling with doctors 64.2% and themselves 29.3% of the patients. In the method of nutrition counseling, 58% of the patients had an individual counseling. In the patients' perception on the nutrition counseling, 75.0% of the patients understood very well, 83.0% of them perceived the explanation as very important, 79.5% were very satisfied and 78.7% were helped in nutrition-management. On a scale of 5.00 for the nutrition counseling satisfaction, the average scores were 3.80 for 'explanation of knowledge', 3.71 for 'cognitive communication skills', 4.05 for 'effective communication skills' and 3.60 for 'facilitation skills'. The items of low scores in the nutrition counseling satisfaction were 'follow up diet-therapy after discharge', 'providing to personalized nutrition information', 'presentation of specific menu' and 'methods of menu planning'. There were significant (p<0.01) positive correlation between perception and satisfaction on the nutrition counseling. Therefore, it was suggested that dietitians increase the patients' satisfaction on the nutrition counseling with developing the model based on the patient-centered counseling.

Clinical Analysis of Mitral Valve Repair with Artificial Chordae (인공 건삭을 이용한 승모판성형술의 임상적 고찰)

  • 이석기;김정중;오삼세;백만종;나찬영;김욱성
    • Journal of Chest Surgery
    • /
    • v.37 no.9
    • /
    • pp.768-773
    • /
    • 2004
  • Failure of mitral valve repair sometimes may be ascribed to severe or progressive alteration of the subvalvar apparatus. The aim of this study was to evaluate the effects of new chordae formation on mitral repair. Material and Method: From March 1997 to february 1999, 26 patients underwent mitral valve repairs with new chordae formation, we compared the symptoms and echocardiographic findings checked at preoperative state, and intraoperative period, discharge, and their last OPD visit. There were 45 male, and 11 female patients, and their mean age was 51.2$\pm$43.4 years. Etiology of the lesions was degenerative (18), rheumatic (6), infective (1) and ischemic (1). Chordal lesions were caused by rupture (18), elongation (6), and a combination of two causes (2). Associated lesions included atrial septal defect (2), tricuspid insufficiency (7), aortic insufficiency(4), and a combination of previous two factors (2). The number of mean artificial chordae was 3.6$\pm$1.6. Annuloplasty was per-formed in all cases. The CPB time was 182,1$\pm$63.7 minutes and the ACC time was 133.1$\pm$45.6 minutes. Aver-age follow up period was 49.2$\pm$7.1 months. Result: There was no early death. Early reoperation was performed in bud patients, one patient received mitral valve replacement because of an abnormality of annuloplasty and ano-ther received pericardiostomy due to postoperative pericardial effusion. During the follow up of 49.2$\pm$7.1 moths, there was no late mortality. Postoperative NYHA functional class checked at last OPD visit was class I in 22 patients (88%), class II in 2 (8%), and class III in 1 (4%). Regarding the late echocardiogram MR was absent in 20 patients (78%), 1 in 4 (15%), and II in 1 (4%). The postrepair mitral valve area was 2.2$\pm$0.35 $\textrm{cm}^2$ Conclusion: This study suggests that mitral valve repair using new chordae formation provides good early and mid term survivals and functional improvement. We think that the artificial chorda formation with polytetrafluoroethylene suture might be safe and effective technique for mitral valve repair.