• Title/Summary/Keyword: Failure area index

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Clinical Analysis on Cancer of the Hypopharynx (하인두암의 임상적 고찰)

  • Kim Young-Ho;Choi Eun-Chang;Hong Won-Pyo;Kim Moon-Suk;Lee Sei-Young;Hong Jung-Pyoe;Chung Hyung-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.46-53
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    • 1998
  • Background: Hypopharyngeal cancer represents about one-third the incidence of laryngeal cancer which is the most common cancer in head and neck area. Although there have been numerous reports regarding its clinical and statistical characteristics, more precise and ample data should be collected and analyzed in this country. Objectives: This study was designed to evaluate the pattern and patient's profile of the hypopharyngeal cancer, and we reviewed the treatment outcomes to search for an index of treatment modalities. Materials and Methods: The authors retrospectively analyzed 73 cases of hypopharyngeal cancer treated at Yonsei Medical Center during the 10-year period from 1985 to 1994. Five-year survival rate was calculated according to the primary site, clinical stage and treatment modality. Results: The incidence was predominated in male by 9 to 1 and peak incidence was 6th and 7th decades. Pyriform sinus was the main primary site(80.8%) followed by posterior hypopharyngeal wall(13.7%) and postcricoid area(5.5%). Advanced stage cancers(87.7%) were more common than early stage cancers. Radiotherapy(60.3%) was the most commonly used as primary treatment modality. Neck node metastasis was early occurred even in early stage cancers(61.5%), and overall rate of neck node metastasis was 69.9%. All surgical cases received procedures more than total laryngectomy and partial pharyngectomy. The most common cause of death was primary failure(81.5%) and it was highest in radiotherapy group. Five-year survival rate was significantly high in surgery group(90.9%). The overall 5-year survival rate of hypopharyngeal cancer was 30.3%. Conclusion: High index of suspicion should be required for early diagnosis. Also, surgery may be recommended for the primary treatment modality in advanced stage cancers.

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Double-Chambered Right Ventricle in an Old Standard Poodle Dog

  • Yunho Jeong;Yoonhwan Kim;Eunchan Lee;Ju-Hyun An;Sooyoung Choi;Jin-Young Chung;Jin-Ok Ahn
    • Journal of Veterinary Clinics
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    • v.40 no.2
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    • pp.130-134
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    • 2023
  • A 12-year-old Standard Poodle presented with intermittent weakness and occasional dyspnea at the Veterinary Medicine Teaching Hospital of Kangwon National University. A grade of 4 out of 6 systolic murmur with an irregular tachycardic rhythm was auscultated on both sides of the chest. Systolic blood pressure was 140 mmHg. Panting was noticed in the hospital, but there was no crackle sound. Blood analysis revealed mild increases in liver panel levels (alanine aminotransferase 149 [reference interval, 19-70] U/L; and alkaline phosphatase, 185 [reference interval, 15-127] U/L) and severe increases in cardiac biomarker levels (n-terminal pro-brain natriuretic peptide, 4169 [reference interval, 50-900] pmol/L; and cardiac troponin I, 0.22 [reference interval, 0.03-0.12] ng/mL). On electrocardiography, irregularly irregular supraventricular tachycardic rhythm with an f-wave and no distinct p-wave was observed. Generalized cardiomegaly with an enlarged right atrium and left ventricle was confirmed on thoracic radiography. Moreover, hepatomegaly and an enlarged caudal vena cava were observed. Echocardiographic evaluation revealed a fibromuscular diaphragm in the right ventricle. Because of the obstructive lesion in the right ventricle, the right atrium and ventricle were enlarged (right atrial area index, 38.82 cm2/m2 [reference interval, 4.2-10.2 cm2/m2]; right ventricle end-diastolic area index, 14.152 cm2/m2 [reference interval, 4.9-10.92 cm2/m2]). Accordingly, the patient was diagnosed with double-chambered right ventricle (DCRV). Pimobendan, furosemide, enalapril, diltiazem, and S-adenosylmethionine (SAMe) were prescribed, and all symptoms were relieved. DCRV is a right-sided congenital heart defect resembling pulmonic valve stenosis. If symptoms are not severe, medical therapy can be facilitated without surgery or the balloon dilation.

Association between Age-Adjusted Endothelial Activation and Stress Index and Intensive Care Unit Mortality in Patients with Severe COVID-19

  • Jong Hwan Jeong;Manbong Heo;Sunghoon Park;Su Hwan Lee;Onyu Park;Taehwa Kim;Hye Ju Yeo;Jin Ho Jang;Woo Hyun Cho;Jung-Wan Yoo;Korean Intensive Care Study Group
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.4
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    • pp.524-531
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    • 2024
  • Background: Endothelial activation and stress index (EASIX) reflects endothelial dysfunction or damage. Because endothelial dysfunction is one of the key mechanisms, a few studies have shown the clinical usefulness of original and age-adjusted EASIX (age-EASIX) in patients with coronavirus disease 2019 (COVID-19). We aimed to evaluate the clinical utility of age-EASIX in predicting intensive care unit (ICU) mortality in critically ill patients with COVID-19 in South Korea. Methods: Secondary analysis was performed using clinical data retrospectively collected from 22 nationwide hospitals in South Korea between January 1, 2020, and August 31, 2021. Patients were at least 19 years old and admitted to the ICU for severe COVID-19, demanding at least high-flow nasal cannula oxygen therapy. EASIX [lactate dehydrogenase (U/L)×creatinine (mg/dL)/platelet count (109 cells/L)] and age-EASIX (EASIX×age) were calculated and log2-transformed. Results: The mean age of 908 critically ill patients with COVID-19 was 67.4 years with 59.7% male sex. The mean log2 age-EASIX was 7.38±1.45. Non-survivors (n=222, 24.4%) in the ICU had a significantly higher log2 age-EASIX than of survivors (8.2±1.52 vs. 7.1±1.32, p<0.001). Log2 age-EASIX was significantly associated with ICU mortality (odds ratio, 1.541; 95% confidence interval, 1.322 to 1.796; p<0.001) and had a better area under the receiver operating characteristic curve than of the sequential organ failure assessment (SOFA) score in predicting ICU mortality (0.730 vs. 0.660, p=0.001). Conclusion: Age-EASIX is significantly associated with ICU mortality and has better discriminatory ability than the SOFA score in predicting ICU mortality.

Flexural performance of cold-formed square CFST beams strengthened with internal stiffeners

  • Zand, Ahmed W. Al;Badaruzzaman, W.H. Wan;Ali, Mustafa M.;Hasan, Qahtan A.;Al-Shaikhli, Marwan S.
    • Steel and Composite Structures
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    • v.34 no.1
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    • pp.123-139
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    • 2020
  • The tube outward local buckling of Concrete-Filled Steel Tube (CFST) beam under high compression stress is still considered a critical problem, especially for steel tubes with a slender section compared to semi-compact and compact sections. In this study, the flexural performance of stiffened slender cold-formed square tube beams filled with normal concrete was investigated. Fourteen (14) simply supported CFST specimens were tested under static bending loads, stiffened with different shapes and numbers of steel stiffeners that were provided at the inner sides of the tubes. Additional finite element (FE) CFST models were developed to further investigate the influence of using internal stiffeners with varied thickness. The results of tests and FE analyses indicated that the onset of local buckling, that occurs at the top half of the stiffened CFST beam's cross-section at mid-span was substantially restricted to a smaller region. Generally, it was also observed that, due to increased steel area provided by the stiffeners, the bending capacity, flexural stiffness and energy absorption index of the stiffened beams were significantly improved. The average bending capacity and the initial flexural stiffness of the stiffened specimens for the various shapes, single stiffener situations have increased of about 25% and 39%, respectively. These improvements went up to 45% and 60%, for the double stiffeners situations. Moreover, the bending capacity and the flexural stiffness values obtained from the experimental tests and FE analyses validated well with the values computed from equations of the existing standards.

Predicting the mortality of pneumonia patients visiting the emergency department through machine learning (기계학습모델을 통한 응급실 폐렴환자의 사망예측 모델과 기존 예측 모델의 비교)

  • Bae, Yeol;Moon, Hyung Ki;Kim, Soo Hyun
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.455-464
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    • 2018
  • Objective: Machine learning is not yet widely used in the medical field. Therefore, this study was conducted to compare the performance of preexisting severity prediction models and machine learning based models (random forest [RF], gradient boosting [GB]) for mortality prediction in pneumonia patients. Methods: We retrospectively collected data from patients who visited the emergency department of a tertiary training hospital in Seoul, Korea from January to March of 2015. The Pneumonia Severity Index (PSI) and Sequential Organ Failure Assessment (SOFA) scores were calculated for both groups and the area under the curve (AUC) for mortality prediction was computed. For the RF and GB models, data were divided into a test set and a validation set by the random split method. The training set was learned in RF and GB models and the AUC was obtained from the validation set. The mean AUC was compared with the other two AUCs. Results: Of the 536 investigated patients, 395 were enrolled and 41 of them died. The AUC values of PSI and SOFA scores were 0.799 (0.737-0.862) and 0.865 (0.811-0.918), respectively. The mean AUC values obtained by the RF and GB models were 0.928 (0.899-0.957) and 0.919 (0.886-0.952), respectively. There were significant differences between preexisting severity prediction models and machine learning based models (P<0.001). Conclusion: Classification through machine learning may help predict the mortality of pneumonia patients visiting the emergency department.

Effects of Non-Pharmacological Interventions on Major Adverse Cardiac Events in Patients Underwent Percutaneous Coronary Intervention: Systematic Review and Meta-Analysis (경피적 관상동맥 중재술을 시행한 대상자에게 적용한 비약물적 중재가 주요 심혈관 사건에 미치는 효과: 체계적 문헌고찰과 메타분석)

  • Jo, Sojeong;Lee, Haejung;Park, Gaeun
    • Journal of Korean Academy of Nursing
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    • v.54 no.3
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    • pp.311-328
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    • 2024
  • Purpose: In this study a systematic review and meta-analysis investigated the impact of non-pharmacological interventions on major adverse cardiac events (MACE) in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). Methods: A literature search was performed using PubMed, Cochrane Library, EMBASE, and Cumulative Index to Nursing & Allied Health Literature databases up to November 2023. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes and 95% confidence intervals were calculated using R software (version 4.3.2). Results: Eighteen randomized studies, involving 2,898 participants, were included. Of these, 16 studies with 2,697 participants provided quantitative data. Non-pharmacological interventions (education, exercise, and comprehensive) significantly reduced the risk of angina, heart failure, myocardial infarction, restenosis, cardiovascular-related readmission, and cardiovascular-related death. The subgroup meta-analysis showed that combined interventions were effective in reducing the occurrence of myocardial infarction (MI), and individual and group-based interventions had significant effects on reducing the occurrence of MACE. In interventions lasting seven months or longer, occurrence of decreased by 0.16 times, and mortality related to cardiovascular disease decreased by 0.44 times, showing that interventions lasting seven months or more were more effective in reducing MI and cardiovascular disease-related mortality. Conclusion: Further investigations are required to assess the cost-effectiveness of these interventions in patients undergoing PCI and validate their short- and long-term effects. This systematic review underscores the potential of non-pharmacological interventions in decreasing the incidence of MACE and highlights the importance of continued research in this area (PROSPERO registration number: CRD42023462690).

Legal Institutional Improvement Measures for Revitalization of Change in Building use Officetel to Lifestyle Lodging Industry (오피스텔의 생활형 숙박업 용도변경 활성화를 위한 제도적 개선방안 연구)

  • Ho, Han-Cheol;Song, Ho-Chang
    • The Journal of the Korea Contents Association
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    • v.14 no.1
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    • pp.455-465
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    • 2014
  • This study focuses on some institutional improvement for revitalization of change in building use of officetel to lifestyle lodging industry. First as analysis method, this study establishes a failure factor for change in building use of officetel to lifestyle lodging industry. Second, analyzes an urgent importance to improve it in aspect of a legal institution or management for revitalizing a change of building use of officetel to lifestyle lodging industry. As a result, a failure factor of change in building use from officetel to lifestyle lodging industry is deducted in 4 articles with 13 detailed index. As a result of AHP, 'existing contractor's 100% agreement condition' is the first place, 'commercial /semi-residential area in zoning' is the second place, 'relative cleanup zone' is the fourth place, 'late changes of building use by a complex licensing procedure' is the fifth place, 'operational risk of consignment' is the sixth place, 'deficiency in publicity of related institution' is the eighth place, 'lack of concept in lifestyle lodging industry of building code' is the ninth place, 'basic constructional condition such as parking lot sewage and fire protection system' is the tenth plce, 'installation of ventilation facility' is the eleventh place, 'installation of bathroom and shower room in each room' is the twelfth place, 'installation of kitchen facility' is the thirteenth place.

LIM Implementation Method for Planning Biotope Area Ratio in Apartment Complex - Focused on Terrain and Pavement Modeling - (공동주택단지의 생태면적률 계획을 위한 LIM 활용방법 - 지형 및 포장재 모델링을 중심으로 -)

  • Kim, Bok-Young;Son, Yong-Hoon;Lee, Soon-Ji
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.3
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    • pp.14-26
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    • 2018
  • The Biotope Area Ratio (BAR) is a quantitative pre-planning index for sustainable development and an integrated indicator for the balanced development of buildings and outdoor spaces. However, it has been pointed out that there are problems in operations management: errors in area calculation, insufficiency in the underground soil condition and depth, reduction in biotope area after construction, and functional failure as a pre-planning index. To address these problems, this study proposes implementing LIM. Since the weights of the BAR are mainly decided by the underground soil condition and depth with land cover types, the study focused on the terrain and pavements. The model should conform to BIM guidelines and standards provided by government agencies and professional organizations. Thus, the scope and Level Of Detail (LOD) of the model were defined, and the method to build a model with BIM software was developed. An apartment complex on sloping ground was selected as a case study, a 3D terrain modeled, paving libraries created with property information on the BAR, and a LIM model completed for the site. Then the BAR was calculated and construction documents were created with the BAR table and pavement details. As results of the study, it was found that the application of the criteria on the BAR and calculation became accurate, and the efficiency of design tasks was improved by LIM. It also enabled the performance of evidence-based design on the terrain and underground structures. To adopt LIM, it is necessary to create and distribute LIM library manuals or templates, and build library content that comply with KBIMS standards. The government policy must also have practitioners submit BIM models in the certification system. Since it is expected that the criteria on planting types in the BAR will be expanded, further research is needed to build and utilize the information model for planting materials.

Stability and Damage Evaluation of the Buddha Triad and 16 Rock-Carved Arhat Statues at Seongbulsa Temple in Cheonan, Korea (천안 성불사 마애석가삼존과 16나한상의 손상도 및 안정성 평가)

  • Yang, Hyeri;Lee, Chan Hee;Jo, Young Hoon
    • Korean Journal of Heritage: History & Science
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    • v.53 no.4
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    • pp.78-99
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    • 2020
  • The Buddha triad and 16 Arhat statues carved on the rock surface at Seongbulsa temple is the only domestic remaining example of all 16 Arhats, so its academic value is very high. However, it is severely damaged and so required a stability evaluation through study of digital documentation and precise diagnosis for the purpose of comprehensive conservation. This process established that the Buddha statues were of similar scale, while the Arhats showed a wide variety of sizes, and the two kith and kin in the volume were larger than the Arhats. It was estimated that the statues of food for Buddha are similar to the Arhat statues, and most of the statues are well-formed. The rock used to carve the Buddha statues is banded gneiss with distinct foliation, alternating between white bands of quartz and feldspar and black bands composed of biotite. The Buddha statues have been damaged by physical weathering, discoloration, and biological contamination. In damage evaluations, joint (3.6 crack index), peeling (5.2%), exfoliation (1.7%), and falling off (0.1%) were observed on the rock surface of the Buddha statues. In particular, due to severe biological weathering, stage 9 and 10 biological coverage of the rock surface accounted for 57.5% of the total area, and stages 5 to 8 also accounted for a high share at 22.3%. The discoloration factors were shown to be dark brown and white with Fe, Ca, and S, and a large amount of C detected in the blackened contaminants, and the damage weight high in all areas. Discontinuities in different directions were identified in the rock surface. Analysis of potential rock failure types indicated that there is a possibility of plane and toppling failure, but wedge failure is unlikely to occur. The mean ultrasonic velocity of the main rock surface was 2,463m/sec, the lower part of the left side with a large number of joints was relatively low, and the highly weathered (HW) type to the completely weathered (CW) type concentrated distribution, showing weak properties. For the Buddha statues, conservation treatment is required for about 14.9% of micro cracks and 58.9% of exfoliation cracks. In addition, in order to improve the conservation environment of the Buddha statues, maintenance of drainage and ground preparations for the rock surface gradient and plants are necessary, and protection facilities should be reviewed for long-term conservation and management purposes.

Effects of Bar Deformation Height on Bond Degradation Subject to Cyclic loading (반복하중시 철근 마디높이에 따른 부착 손상특성)

  • Lee, Jae-Yuel;Kim, Byong-Kook;Hong, Gi-Suop;Choi, Oan-Chul
    • Journal of the Korea Concrete Institute
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    • v.15 no.1
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    • pp.17-24
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    • 2003
  • One of the reasons for brittle failure in reinforced concrete structures subjected to severe earthquake is due to large local bond-slippage of bars resulting in fast bond degradation between reinforcing bars and concrete. This study aims to evaluate effects of bar deformation height on bond performance, specially, bond degradation under cyclic loading. Bond test specimens were constructed with machined bars with high relative rib areas. The degree of confinement by transverse bars is also another key parameters in this bond test. From test results, amounts of energy dissipation are calculated and compared for each parameter. Test results show that bond strength and stiffness drops significantly as cycles increases. The confinement and high relative rib area are effective to delay bond degradation, as the reduction of bond strength of cyclic loading compared to monotonic loading decreased for bars with large confinement and high relative rib areas. The energy dissipation also increases as the degree of confinement and relative rib area increases. However, tested bars with very high rib areas show that the bond may be damaged at relatively small slip because of high stiffness. The study will help to understand the bond degradation mechanism due to bar deformation height under cyclic loading and be useful to develop new deformed bars with high relative rib areas.