The Sunrise Dam gold deposit is located approximately 850 km ENE of Perth, in the eastern part of the Yilgam Craton, Western Australia. The mine has produced approximately 153 t of Au at an average grade of 4.2 g/t, which stands for the most significant gold discoveries during the last decade in Western Australia. The deposit occurs in the Laverton Tectonic Zone corresponding to the corridor of structural complexity in the Laverton greenstone belt, and characterized by tight folding and thrusting. The mine stratigraphy consists of a complexly deformed and altered volcaniclastic and volcanic rocks. These have been overlain by a turbidite sequence containing generally well-sorted siltstones, sandstones and magnetite-rich shales, which are consistently fining upwards. These sequences have been intruded by quartz diorite, ultramafic dikes, and rhyodacite porphyry (Archean), and lamprophyre dikes (Palaeoproterozoic). These rocks constitute the asymmetric NNE-trending Spartan anticline with north-plunging thrust duplication of the BIF unit. The deposit is located on the western limb of this structure. Transported, fluvial-lacustrine and aeolean sediments lie unconformably over the deposit showing significant variation in relief. Gold mineralization occurs intermittently along a NE-trending corridor of ca. 4.5 km length. The 20 currently defined orebodies are centered on a series of parallel, gently-dipping ($\sim30^{\circ}$) and NESW trending shear zones with a thrust-duplex architecture and high-strain characteristics. The paragenetic sequence of the Sunrise Dam deposit can be divided into five hydrothermal stages ($D_1$, $D_2$, $D_3$, $D_4a$, $D_4b$), which are supported by distinctive features of the mineralogical assemblages. Among them, the D4a stage is the dominant episode of Au deposition, followed by the $D_4b$ stage, which is characterized by more diverse ore mineralogy including base metal sulfides, sulfosalts, and telluride minerals. The $D_4a$ stage contains higher proportions of microscopic free gold (48%) than D4b stage (12%), and pyrite is the principal host for native gold (electrum) followed by tetrahedrite-group minerals in both stages.
Objective: To find out clinical features and long-term outcomes of idiopathic childhood nephrotic syndrome(NS) patients with late steroid resistance(LSR)/late steroid sensitiveness(LSS). Patients and Methods: A retrospective chart review was performed on 480 patients diagnosed with idiopathic childhood NS at Asan Medical Center Children's Hospital from 1990 to 2013. Twenty-four patients whose responsiveness to steroids changed over a minimum 2 year follow-up period (2-17.5 years) were investigated. All patients had undergone a renal biopsy. Results: Among 480 nephrotic children, 428 (89%) were sensitive to the first steroid course. Of those who initially responded, 11 (2.5%) developed resistance to steroid therapy after relapses. LSR mostly developed between 1 month and 1 year after the initial episode. Six patients showed a minimal change and five showed focal segmental glomerulosclerosis (FSGS). Nine (82%) responded to cyclosporine or methylprednisolone pulse therapy. Of these, two had no further relapse, whereas the other seven experienced several relapses that ranged in length from 1.1 to 13.9 years. Three of the nine who initially responded to immunosuppression went on to experience several changes in steroid responsiveness. Two (18%) with resistance to immunosuppressants, including steroids, eventually progressed to end stage renal disease. Among the 52 patients (11%) who were initially steroid resistant, 13 (23%) were converted to steroid sensitive at relapses. Among these, 9 showed minimal change and 4 showed FSGS. Two had no further relapse and the other 11 responded to steroids on subsequent relapses ranging in length from 1.3 to 9.4 years. All these patients have had no further changes in steroid responsiveness with normal renal function. Conclusions: In this study, 2.5% of initial steroid responders and 25% of initial steroid non-responders changed their responsiveness to steroids at subsequent relapses. Eighteen percent of LSR patients developed end stage renal disease. All of the LSS patients showed preserved normal renal function. Responsiveness to immunosuppressants seemed to be the most important factor determining longterm outcomes in LSR/LSS patients.
A 9-month-old, female Miniature Pinscher(MP) dog weighing 1.97kg was presented because of periodic syncopal episode for 5 months. This case was diagnosed as primary dilated cardiomyopathy based on respiratory distress history, weak femoral pulse, generalized cardiomegaly, pulmonary edema, marked dilation of left atrium(LA) and left ventricle(LV), decreased wall thickness of LV and interventricular septum(IVS), increased EPSS in echocardiography, and young age of onset in the absence of other cardiovascular disorders. The patient was stabilized by application of diuretics(Furosemide, 2 mg/kg, SC, q 1 hr) and venodilator(Nitroglycerine patch, 0.5 mg/kg, q 12 hrs). Clinical signs were improved with medical management of positive inotropic vasodilator(Pimobendan, 0.2 mg/kg, PO, q 12 hrs) and angiotensin-converting enzyme(ACE) inhibitor(benazepril, 0.5 mg/kg, PO, q 12 hrs), potassium gluconate gel(2 mEq/dog, PO, q 12 hrs) and, L-carnitine(50 mg/kg, PO, q 12 hrs). The dog still maintains stable clinical status 10 months after the first visit. We report the rare case of DCM in small breed dog, which corresponds to the diagnosis and treatment of typical DCM in large breed dog.
This is a report on four cases of the lobar emphysema due to proximal bronchial obstruction in the Department of Thoracic Surgery, Hanyang University Hospital, during the period of three and half years from 1972 to 1975. First case, a two years old male child was referred to our Department with the lobar emphysema of the lower lobe of the right lung with pneumonia. This emphysema was developed after aspiration of a piece of peanut. Bronchoscopy revealed that the bronchus of the right lower lobe was obstructed with the foreign body, however removal of the peanut through bronchoscope was not attempted because of corruption and softening of the peanut. The removal of the peanut by bronchotomy was performed after subsiding of acute phase of pulmonary infection. Postoperative course was uneventful and the emphysema was disappeared. Second case, a twenty months old female baby was referred to our Department with lobar emphysema of the lower lobe of the left lung. The emphysema was suddenly developed with coughing and dyspneic symptoms and the diagnosis was made roentgenologically. She gave a history of reccurrent infections of the respiratory tract after birth. Bronchoscopy showed an obstruction of the left main bronchus with the growing of fibrinous tissue on the bronchial mucosa. The protruded tissue in the left main bronchus taken out about O.8ml with biopsy forceps for histological examination. After this procedure, the emphysema of the left lung was disappeared. Histological finding was reported to be a chronic inflammatory granulation tissue. Third case, a two and half years old male child was referred to our Department with roentgenological lobar emphysema. Two weeks prior to admission he had an episode of sudden onset of coughing attack with dyspnea. Bronchoscopy revealed that the bronchus of the left lower lobe was obstructed with a mass which was strongly suspected of a neoplastic tissue. At operation, there was found a perforation of enlarged tuberculous lymph node in the bronchus of the left lower lobe and protrusion of granulation tissue into the bronchus. Ruptured orifice on themembranous wall of the left lower lobe bronchus was closed with interrupted suture after the" removal of a perforated tuberculous lymph node. Postoperative course was uneventful and antituberculous chemotherapy was given. Fourth case, a 47 years old man was admitted to our Department with the complaint of severe dyspnea of few months duration. Twenty years ago, he had a history of lung tuberculosis and was treated for many years. X-ray examination including tomography and bronchography revealed that the upper lobe of the right lung was destroyed with cavities, the lower lobe was completely shrunk, and the right middle lobe was strongly overdistended with narrowing bronchial trees. Differential bronchospirometry and lung scanning confirmed that the respiratory function of the affected lung was impaired almost totally. The value of the right lung was calculated on 6% of oxygen uptake, 1% of Minute volume, and 32% of vital capacity. The right pneumonectomy was performed under the careful consideration of anesthetic and surgical procedures. Postoperative course was uneventful and the respiratory function was improved nearly to the normal level.evel.
Hur, Chae Wook;Choi, Chang Hwa;Cha, Seung Heon;Lee, Tae Hong;Jeong, Hae Woong;Lee, Jae Il
Journal of Korean Neurosurgical Society
/
v.58
no.3
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pp.184-191
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2015
Objective : Anterior communicating artery (AcomA) aneurysms represent the most common intracranial aneurysms and challenging to treat due to complex vascularity. The purpose of this study was to report our experience of endovascular treatment of AcomA aneurysms. Methods : Between January 2003 and December 2013, we retrospectively reviewed the medical records of 134 AcomA aneurysm patients available more than 6 months conventional angiographic and clinical follow-up results. We focused on aneurismal or AcomA vascular characters, angiographic and clinical follow-up results, and retreatment. Results : The rate of ruptured cases was 75.4%, and the small (<10 mm) aneurysms were 96.3%. Based on the subtypes defined by dominance of A1, 79 patients (59%) had contralateral A1 hypoplasia or agenesis. The immediate post-procedural angiography confirmed complete occlusion in 75.4%, partial occlusion in 24.6%. Procedure related complications were observed in 25 (18.6%) patients. Most of the adverse events were asymptomatic. Follow-up conventional angiography at ${\geq}6$ months was performed in all patients (mean 16.3 months) and major recanalization was noted in 6.7% and regrowth in one case. The aneurysm size (p=0.016), and initial treatment results (p=0.00) were statistically significant risk factors related to aneurysm recurrence. An overall improvement in mRS was observed during the clinical follow-up period and no rebleeding episode occurred. Conclusion : This study demonstrated that endovascular treatment is an effective treatment modality for AcomA aneurysms with low morbidity. Patients should take long term clinical and angiographic follow-up in order to assess the recurrence and warrant retreatment, especially ruptured, large, and initially incomplete occluded aneurysms.
Lim, Myeong Soon;Moon, Il-Ju;Cha, Yu-Mi;Chang, Ki-Ho;Kang, Ki-Ryong;Byun, Kun Young;Shin, Do-Shick;Kim, Ji Young
Atmosphere
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v.24
no.3
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pp.283-301
/
2014
In 2010, only 14 tropical cyclones (TCs) were generated over the western North Pacific (WNP), which was the smallest since 1951. This study summarizes characteristics of TCs generated in 2010 over the WNP and investigates the causes of the record-breaking TC genesis. A long-term variation of TC activity in the WNP and verification of official track forecast in 2010 are also examined. Monthly tropical sea surface temperature (SST) anomaly data reveal that El Ni$\tilde{n}$o/Southern Oscillation (ENSO) event in 2010 was shifted from El Ni$\tilde{n}$o to La Ni$\tilde{n}$a in June and the La Ni$\tilde{n}$a event was strong and continued to the end of the year. We found that these tropical environments leaded to unfavorable conditions for TC formation at main TC development area prior to May and at tropics east of $140^{\circ}E$ during summer mostly due to low SST, weak convection, and strong vertical wind shear in those areas. The similar ENSO event (in shifting time and La Ni$\tilde{n}$a intensity) also occurred in 1998, which was the second smallest TC genesis year (16 TCs) since 1951. The common point of the two years suggests that the ENSO episode shifting from El Ni$\tilde{n}$o to strong La Ni$\tilde{n}$a in summer leads to extremely low TC genesis during La Ni$\tilde{n}$a although more samples are needed for confidence. In 2010, three TCs, DIANMU (1004), KOMPASU (1007) and MALOU (1009), influenced the Korean Peninsula (KP) in spite of low total TC genesis. These TCs were all generated at high latitude above $20^{\circ}N$ and arrived over the KP in short time. Among them, KOMPASU (1007) brought the most serious damage to the KP due to strong wind. For 14 TCs in 2010, mean official track forecast error of the Korea Meteorological Administration (KMA) for 48 hours was 215 km, which was the highest among other foreign agencies although the errors are generally decreasing for last 10 years, suggesting that more efforts are needed to improve the forecast skill.
The distribution and inter-annual variation of nutrients (N, P, Si) and dissolved/particulate organic carbon were investigated in the equatorial thermocline ridge ($7^{\circ}{\sim}11.5^{\circ}N$, $131.5^{\circ}W$) of the northeast Pacific. From the Oceanic Nino Index and Multivariate ENSO Index provided by NOAA, normal condition was observed in July 2003 and August 2005 on the aspect of global climate/ocean change. However, La Ni$\~{n}$a and El Ni$\~{n}$o episodes occurred in July 2007 and August 2009, respectively. Thermocline ridge in the study area was located at $9^{\circ}N$ in July 2003, $8^{\circ}N$ in August 2005, $10^{\circ}N$ in July 2007, and $10.5^{\circ}N$ in August 2009 under the influence of global climate/ocean change and surface current system (North Equatorial Counter Current and North Equatorial Current) of the northeast Pacific. Maximum depth integrated values (DIV) of nutrients in the upper layer (0~100 m depth range) were shown in July 2007 (mean 21.12 gN/$m^2$, 4.27 gP/$m^2$, 33.72 gSi/$m^2$) and higher variability of DIV in the equatorial thermocline ridge was observed at $10^{\circ}N$ during the study periods. Also, maximum concentration of dissolved organic carbon (DOC) in the upper 50 m depth layer was observed in July 2007 (mean $107.48{\pm}14.58\;{\mu}M$), and particulate organic carbon (POC, mean $9.42{\pm}3.02\;{\mu}M$) was similar to that of DOC. Nutrient concentration in the surface layer increased with effect of upwelling phenomenon in the equatorial thermocline ridge and La Ni$\~{n}$a episode, which had formed in the central Pacific. This process also resulted in the increasing of organic carbon concentration (DOC and POC) in the surface layer. From these results, it is suggested that spatial and temporal variation of chemical and biological factors were generated by physical processes in the equatorial thermocline ridge.
One metabolism trial(Experiment I) and another respiration trial(Experiment II) were conducted to investigate the effects of dietary fiber supplementation(20% wheat bran) on the water balance, blood acid-base balance, body temperature, and metabolic rate of heat-stressed adult roosters. In Experiment I, twenty 20-wk-old SCWL roosters(BW 1.6 kg) were randomly alloted to 4 treatments with 5 birds per treatment and one per replicate. The 4 treatments were consisted of two temperature(21~22˚C vs. 34~35˚C) and two dietary fiber treatment(0% and 20% wheat bran), making Experiment I a 2x2 factorial. After 4 d of preliminary period, birds we subjected to 3-d collection period. Sixteen 20-wk-old SCWL roosters(BW 1.6 kg) were employed Experiment H, with two temperature(21~22˚C vs. 34~35˚C) and two wheat bran levels(0% and 20%). Brids were housed in individual metabolism cages under normal temperature(21~22˚C), at fed one of the experimental diet. After 4 d of preliminary period, a respiration trial with open-circuit gravimetric respiratory apparatus was carried out for each bird for 6 h, one by one, normal(20~21˚C) and hot(34~35˚C) temperatures. The ANOVA test and comparisons among treatment means were done at 5% probability level for both experiments. Results obtained from Experiment I and, II were summarized as follows, 1.The amounts of DM intake and excretion were significantly(P<.05) decreased by heat stress. The DM intake was not affected by the addition of 20% wheat bran, however, the amount of DM excretion was significantly increased by the high fiber diet. Thus, the DM metabolizability decreased significantly by the addition of 20% wheat bran. 2. The heat-stressed roosters increased the water intake and excreta moisture content significantly. Although not significant, the water intake tended to increase in roosters fed the 20% wheat bran diet. 3. The amounts of total water input and evaporative water loss were increased significantly by heat stress, and the addition of 20% wheat bran did not exert any influence on the total water input and evaporative water loss. However, roosters fed the 20% wheat bran diet increased the excreta water output significantly. 4. Neither the heat stress nor the dietary fiber did affect the blood pH, pCO2, and HCO$_3$- significantly. 5. The body temperature increased significantly by the heat stress. However, the high fiber deit failed to decrease the body temperature. 6. The heat-stressed roosters decreased the 02 consumption and C0$_2$ production, and increased the evaporative water loss significantly. However, the high fiber diet did not exert any infulence in this regard. It appears that the beneficial effect, if any, of high fibrous diet during heat stress episode may be due to the increased heat loss through the enhanced excreta water.
In this study, the parameters of Polysomnography (PSG) test, such as total sleep time, snoring time, had been analyzed to evaluate the effectiveness of a developed anti-snore pillow. The developed anti-snore pillow is made up of two polyvinylidene fluoride (PVDF) vibration sensors, pumps, valves, and air bladders. The two PVDF sensors inside the pillow can acquire the sound signals and the algorithm was perfectly designed to extract snoring by removing unwanted noise accurately and automatically. Once the pillow recognizes snore, a pump inside the hardware activates, and a bladder under the neck area inside the pillow will be inflated. The PSG test was used and two volunteers were participated for the study. The parameters of the PSG results were analyzed to evaluate the effectiveness of the anti-snore pillow. The total sleep time of each volunteer was similar on each phase of test, but the snoring time and the longest snoring episode were significantly decreased with the use of anti-snore pillow. The overall results showed excellent possibilities for reducing snoring for the person who snores during sleep by using the anti-snore pillow. The effectiveness of the anti-snore pillow can be evaluated by the PSG test. Moreover, the relationship between each parameter of PSG test and the quality of sleep will be used for further researches.
Shin, Dong Gyo;Lee, Chun Kyoon;Lee, Sang Gyu;Kang, Jung Gu;Sun, Young Kyu;Park, Eun-Cheol
Health Policy and Management
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v.23
no.1
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pp.35-43
/
2013
Background: Diagnosis procedure combination (DPC) has recently been introduced in Korea as a demonstration project and it has aimed the improvement of accuracy in bundled payment instead of Diagnosis related group (DRG). The purpose of this study is to investigate that the model of end-stage liver disease (MELD) score as the severity classification of liver diseases is adequate for improving reimbursement of DPC. Methods: The subjects of this study were 329 patients of liver disease (Korean DRG ver. 3.2 H603) who had discharged from National Health Insurance Corporation Ilsan Hospital which is target hospital of DPC demonstration project, between January 1, 2007 and July 31, 2010. We tested the cost differences by severity classifications which were DRG severity classification and clinical severity classification-MELD score. We used a multiple regression model to find the impacts of severity on total medical cost controlling for demographic factor and characteristics of medical services. The within group homogeneity of cost were measured by calculating the coefficient of variation and extremal quotient. Results: This study investigates the relationship between medical costs and other variables especially severity classifications of liver disease. Length of stay has strong effect on medical costs and other characteristics of patients or episode also effect on medical costs. MELD score for severity classification explained the variation of costs more than DRG severity classification. Conclusion: The accuracy of DRG based payment might be improved by using various clinical data collected by clinical situations but it should have objectivity with considering availability. Adequate compensation for severity should be considered mainly in DRG based payment. Disease specific severity classification would be an alternative like MELD score for liver diseases.
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