• Journal of Chest Surgery
• /
• v.31 no.9
• /
• pp.827-836
• /
• 1998

Background: Effective cardiopulmonary resuscitation (CPR) should provide acceptable hemodynamics for the vital organs during cardiac arrest and early restoration of spontaneous circulation that guarantees long-term, neurologically intact survival. CPR using heart-lung bypass has been suggested as an option for that use. This study was designed to determine the effectiveness of standard CPR techniques, closed-vs. open-chest CPR, which could be used in the future study verifying the role of heart-lung bypass CPR. Material and Method: By using adult mongrel dogs, closed-chest CPR (CCCPR, n=4) and open-chest CPR (OCCPR, n=5) were compared with respects to hemodynamics, restoration of spontaneous circulation(ROSC), and survival. Ventricular fibrillation-cardiac arrest (VF-CA) was induced by electrical shock in all animals. After 4 minutes of cardiac arrest, basic life support (BLS) was applied for 15 minutes and followed by advanced life support (ALS). ALS was maintained until achi ving ROSC but not longer than 30 minutes regardless of the recovery. Resuscitation procedures in either group were standardized by adopting the protocol of American Heart Association. Result: Prearrest baseline hemodynamic data was not different between two groups. During resuscitation, substantially higher systolic pressure was maintained in OCCPR group than in CCCPR group (45$\pm$15 vs. 33$\pm$11 mmHg during BLS, 83$\pm$36 vs. 44$\pm$15 mmHg during ALS; p=NS). Mean pulmonary arterial pressure went up to the level of mean systemic arterial pressures in CCCPR group and to half of that in OCCPR group, and had kept higher in CCCPR group throughout CPR (32$\pm$10 vs. 22$\pm$4 mmHg during BLS and 32$\pm$15 vs. 24$\pm$10 mmHg during ALS; p=NS). ROSC was obtained in 4 of 5 dogs receiving open-chest CPR and 2 of 4 closed-chest CPR. Prolonged survival was noted in all dogs in OCCPR group (6 to 1440 hours) but not in CCPR group (p<.05). Conclusion: These findings indicate that open-chest CPR can be more effective t maintain hemodynamics during cardiac arrest and to obtain restoration of spontaneous circulation and survival. Further experiment will be designed to compare heart-lung bypass CPR with open-chest CPR.

• Journal of Chest Surgery
• /
• v.40 no.2 s.271
• /
• pp.114-121
• /
• 2007

Background: Apoptosis plays a crucial role in carcinogenesis, as well as in development and tissue homeostasis. Terminal deoxyribonucleotidyl transferase mediated neck end labelling (TUNEL) and in situ nick end labelling (ISEL) have been used to investigate the apoptosis in tissues. Since the introduction of the M30 monoclonal antibody to overcome drawbacks of TUNEL and ISEL, the apoptosis in various tumors, with the exception of pulmonary carcinomas, has been studied. In this study, attempts were made to examine the correlation of apoptosis in non-small cell carcinomas, using both M30 and the expression of p53 protein, with the clinicopathological factors. Material and Method: Forty five patients with surgically resected non-small cell carcinomas were included. Immunohistochemical staining with M30 and p53 monoclonal antibody were peformed, and their expressions compared with the clinicopathological features. The overall survival time and recurrence-free survival time were calculated, and the factors influencing the survival time analyzed using a univariate analysis. The effects of the expression stati of M30 and p53 on the risks of cancer related to both death and recurrence were evaluated using a multivariate analysis. Result: The p53 positive group had many more M30 positive cells than the p53 negative group (p53 positive group; $61.7{\pm}26.8$ cells vs. p53 negative group; $45.6{\pm}29.6$ cells, p=0.005) and significantly more p53 positive patients showing at least 10 positive cells (apoptotic index, $Al{\ge}1$) on M30 staining (p53 positive group; 52.4% (11/21) vs. p53 negative group 16,7% (4/24), p=0.025). In the univariate analysis, the survival times in relation to smoking (pack-year), performance status (PS) and Al showed significant differences. The multivariate analysis demonstrated the relative risk (R.R) of cancer death increased almost 7.5-fold (R.R 7.482; 95% Cl $1.886{\sim}29.678$; p=0.004) and the risk of recurrence almost 3,8-fold (R.R 3.795; 95% Cl: $1.184{\sim}12.158$; p=0.025) in the high Al (${\ge}1$) compared to the low Al (<1) group. There was no prognostic effect of p53 expression on the survival time or risk of cancer death and recurrence. Conclusion: In non-small cell lung carcinomas, M30 immunohistochemistry was an excellent method for analyzing apoptosis; the high apoptotic index could be an adverse prognostic predictive factor.

• Journal of Chest Surgery
• /
• v.40 no.6 s.275
• /
• pp.407-413
• /
• 2007

Background: The brain natriuretic peptide (BNP) level has been reported in some studies to be associated with the occurrence of atrial fbrillation (AF). The aim of this study is to evaluate the potential usefulness of the BNP level as a predictor of the occurrence of postoperative (postop) AF and to assess the relationship of the BNP level with the onset of AF and the restoration of sinus rhythm. Material and Method: From January 1, 2005 to February 28, 2006, 82 patients without a history of atrial arrhythmia that had undergone cardiac surgery were enrolled in the study. Blood samples for plasma BNP were drawn daily for all these patients from the preoperative (preop) day to the 7th postop day. The patient records were reviewed and postop EKGs were checked daily for AF until the time of discharge. Result: Patients were divided into two groups based on development of postop AF. Postoperative AF developed in 26 patients (31.7%). There was no significant statistical difference in age, sex distribution, preop left ventricle ejection fraction, hypertension, left ventricular hypertrophy, or the use of beta blockers between the non-postop AF and postop AF group. More patients in the AF group had undergone valve surgery (39.3% versus 76.9%, p=0.002). The preop left atrium size was significantly larger in the AF patients ($43.8{\pm}10.3 mm$ versus $49.8{\pm}11.5 mm$, p=0.029). The preop plasma BNP levels were higher in the postop AF patients ($144.1{\pm}20.8 pg/mL$ versus $267.5{\pm}68 pg/mL$, p=0.034). In the postop AF group, the plasma BNP level was the highest on the 3rd postop day. Postop AF developed in most patients by the 3rd postop day; restored sinus rhythm developed by the 7th postop day. Conclusion: Elevated plasma BNP levels may lead to the occurrence of postop AF in patients undergoing cardiac surgery. Patients who have a high risk of postop AF should be considered for aggressive prophylactic antiarrhythmic therapy.

• Korean Journal of Soil Science and Fertilizer
• /
• v.39 no.5
• /
• pp.268-273
• /
• 2006

Soil loss induced by erosion has come to be a serious problem in Korea's sloped land since more than 70% of upland fields are located on the sloped land area. The purpose of this study was to investigate the phase of water flow in differently soil textured plot soil types by rainfall amount. Lysimeters with slope of 15%, 5 m in length, 2 m in width, and 1 m in depth were prepared and filled up with three different soil textures, such as sandy loam, loam, and clay loam, then relationships between seasonal rainfall and runoff, percolation were analyzed. Runoff and percolation rate were shown to increase linearly with increasing rainfall intensity in all the soil textures, but the starting threshold and increment rate in runoff and percolation occurrence were dependent differently upon soil textures. Percolation increment rate according to the increasing rainfall amount was 0.52, 0.36, and 0.57 for sandy loam, loam and clay loam soil respectively. The threshold rainfall amounts in which percolation occurs were 5.73 mm, 6.80 mm, and 12.86 mm for sandy loam, loam and clay loam respectively. Runoff increment rates were 0.42, 0.48 and 0.46 for sandy loam, loam and clay loam soil. The threshold rainfall amount in which runoff occurs was 10.50 mm in sandy loam, 7.76 mm in loam and 17.40 mm in clay loam. These different phases of water flow by soil texture could be used to suggest guidelines for the best management practice of the farming slope land.

• Journal of Korean Society of Transportation
• /
• v.19 no.1
• /
• pp.101-114
• /
• 2001

Transportation enterprises should maintain constant and qualitative operation. Thus, in short period, transportation enterprises don't change supply in accordance with demand. In the result, transportation enterprises don't reduce operation in spite of management deficit at will. In freight transportation type, less-than-truckload(LTL) has more relation with above transportation feature than truckload(TL) does. Because freight transportation supply of TL is more flexible than that of LTL in correspondence of freight transportation demand. Relating to above mention, it appears that shortage of road and freight terminal of LTL is larger than that of TL. Especially in road and freight terminal comparison, shortage of freight terminal is larger than that of road. Shortage of road is the largest in 1990, and improved after-ward. But shortage of freight terminal is serious lately. So freight terminal needs more expansion than road, and shows better investment condition than road. Freight terminal expansion brings road expansion in LTL, on the contrary, freight terminal expansion substitutes freight terminal for road in TL. In transportation revenue, freight terminal's contribution to LTL is larger than that to TL. However, when we adjust quasi-fixed factor - road and freight terminal - to optimal level in the long run, in TL, diseconomies of scale becomes large, but in LTL, economies of scale becomes large. Consequently, it is necessary for TL to make counterplans to activate management of small size enterprises and owner drivers. And LTL should make use of economies of scale by solving the problem, such as nonprofit route, excess of rental freight handling of office, insufficiency of freight terminal, shortage of driver, and unpreparedness of freight insurance.

• Radiation Oncology Journal
• /
• v.20 no.3
• /
• pp.193-198
• /
• 2002

Purpose : Oligodendrogliomas (ODG) are a rare, slow growing, tumor in the brain, which can be cured by complete surgical resection, but as yet it is not known if postoperative adjuvant radiation therapy (RT) is essential, We analyzed the treatment results of patients with irradiated ODG to investigate the efficacy of RT in terms of survival rates and other influencing prognostic factors. Methods and Materials : Between March 1983 and December 1997, 42 patients with ODG were treated with RT at our hospital. The RT was peformed dally at a dose of $1.8\~2.0\;Gy$, at 5 fractions per week, to a total dose of between 39.6 Gy and 64.8 Gy (mean 53.3 Gy). The ages of the patients ranged between 5 and 62 years, with a median age of 39 years. The mean follow-up period was 63.4 months (8-152 months). The Kaplan-Meier method was used to assess the survival, and 5 year survival rates (5-YSR). Log rank tests and Cox regression analyses were used to define the significance of prognostic factors. Results : The majority of ODG in this study were located in the cerebral hemisphere $(83.3\%)$. ODG are slightly more common in men than women, and commonly occurs in middle age, between the 3rd and 4th decades. It has been recommended that RT is commenced within 4 weeks following surgery (5-YSR; $86\%\;vs.\;49\%;\;p<0.03$). Histologically well differentiated, as opposed to poorly differentiated, tumors were found to have a more favorable prognosis (p<0.02). The actuarial 5-YSR was $65.3\%$ (median survival 90 months). 5-YSR for the various extents of surgical excision, followed by external RT, was superior to that of biopsy only followed by external RT $(69.9\%\;vs.\;25.6\%,\;p<0.01)$. Tumor size and location, overall elapsed irradiation days, age, sex, whole brain irradiation as a course of treatment and chemotherapy, had no influence on the 5-YSR (p>0.05). Conclusion : A local involved field irradiation with conventional fractionation, commencing within 4 weeks following surgical excision of the tumor, was beneficial for the 5-YSR, but a total radiation dose exceeding 60 Gy did not improve the 5-YSR.

• Clinical and Experimental Pediatrics
• /
• v.49 no.7
• /
• pp.777-783
• /
• 2006

Purpose : Urinary tract infection(UTI) is one of the most frequent infections in children. E. coli is the most frequent etiological micropathogen in pediatric community UTI, and E. coli has developed resistance to many antibiotics, highlighting the need for regular surveys of this organism resistant patterns in the community. The aim of this study was to determine the oral antibiotic susceptibility patterns of E. coli, isolated from pediatric patients with uncomplicated community acquired UTI. Methods : E. coli isolates, obtained from pediatric patients with uncomplicated community acquired UTI between October in 2004 to September in 2005. And minimal inhibitory concentrations(MICs) of oral aminopenicillins and beta-lactamase inhibnitors(ampicillin, amoxacillin, ampicillin-sulbactam), oral cephalosporins(cefaclor, cefixime) and sulfa drug(trimethoprime-sulfamethoxazole) were performed according to the National Committee for Clinical Laboratory Standards(NCCLS) guide line. Results : Total 211 organisms were isolated from pediatric out-patients with community UTI. E. coli was the most common organism(89 percent), followed by E. fecalis, Proteus species, S. aureus, M. morganii, and P. aeruginosa. The resistant rates of aminopenicillins and beta-lactamase inhibitors, cefaclor and sulfa drug to E. coli were very high. But, the resistant rate of cefixime was markedly low, and ESBL strains were isolated with small rates. Conclusion : Our study results suggest that aminopenicillins, cefaclor and sulfa drug may not be useful as first line empirical antibiotics to treat pediatric patients with community UTI in Korea. But, 3rd generation cephalosporin such as cefixime can be used as effective second line antibiotics after primary treatment failure, also may be useful as an empirical first line antibiotic. Finally, we conclude that a continuous surveillance study to monitor susceptibility patterns of E. coli in community UTI will be needed for the standard guide lines of empirical oral antibiotic treatment.

• Pediatric Infection and Vaccine
• /
• v.18 no.2
• /
• pp.135-142
• /
• 2011

Purpose : Hospital associated infection (HAI) caused by multidrug-resistant (MDR) microorganisms has been recognized as an important issue in the world, especially in critically ill patients such as the patients admitted in the intensive care unit. There are fewer papers about MDR-HAI in pediatric patients compared to adult patients. In this study, we investigated the incidence and associated factors of MDR-HAI in children admitted to the intensive care unit (ICU) of a university hospital. Methods : We retrospectively evaluated 135 children who were admitted in ICU for at least 3 days between January 2009 and December 2010. HAI cases were divided into MDR-HAI group and non-MDR-HAI group. Clinical characteristics and various associated factors were compared between those groups. Results : In 39 patients, 45 cases of ICU-related HAI were developed. ICU-related HAI incidence was 47.7 per 1000 patientdays. Thirty-six cases (80.0%) were MDR-HAI. Acinetobacter baumannii was isolated more commonly in MDR-HAI group. And the followings were found more frequently in MDR-HAI group than non-MDR-HAI group: medical condition as an indication for ICU admission, mechanical ventilation, urinary catheterization and previous use of broad-spectrum antibiotics. Among the risk factors, previous use of broad-spectrum antibiotics was the independent risk factor for MDR-HAI. Conclusion : ICU-related HAI incidence was higher than previously reported. Previous use of broad-spectrum antibiotics was the independent risk factor for MDR-HAI. To investigate the characteristics of MDR-HAI in children admitted in ICU, further studies with a larger sample size over a longer period of time are warranted.

• Asia pacific journal of information systems
• /
• v.23 no.2
• /
• pp.21-39
• /
• 2013

As the utilization of information technology and the turbulence of technological change increase in organizations, the adoption of IT outsourcing also grows to manage IT resource more effectively and efficiently. In this new way of IT management technique, service level management(SLM) process becomes critical to derive success from the outsourcing in the view of end users in organization. Even though much of the research on service level management or agreement have been done during last decades, the performance of the service level management process have not been evaluated in terms of final objectives of the management efforts or success from the view of end-users. This study explores the relationship between SLM maturity and IT outsourcing success from the users' point of view by a analytical case study in four client organizations under an IT outsourcing vendor, which is a member company of a major Korean conglomerate. For setting up a model for the analysis, previous researches on service level management process maturity and information systems success are reviewed. In particular, information systems success from users' point of view are reviewed based the DeLone and McLean's study, which is argued and accepted as a comprehensively tested model of information systems success currently. The model proposed in this study argues that SLM process maturity influences information systems success, which is evaluated in terms of information quality, systems quality, service quality, and net effect proposed by DeLone and McLean. SLM process maturity can be measured in planning process, implementation process and operation and evaluation process. Instruments for measuring the factors in the proposed constructs of information systems success and SL management process maturity were collected from previous researches and evaluated for securing reliability and validity, utilizing appropriate statistical methods and pilot tests before exploring the case study. Four cases from four different companies under one vendor company were utilized for the analysis. All of the cases had been contracted in SLA(Service Level Agreement) and had implemented ITIL(IT Infrastructure Library), Six Sigma and BSC(Balanced Scored Card) methods since last several years, which means that all the client organizations pursued concerted efforts to acquire quality services from IT outsourcing from the organization and users' point of view. For comparing the differences among the four organizations in IT out-sourcing sucess, T-test and non-parametric analysis have been applied on the data set collected from the organization using survey instruments. The process maturities of planning and implementation phases of SLM are found not to influence on any dimensions of information systems success from users' point of view. It was found that the SLM maturity in the phase of operations and evaluation could influence systems quality only from users' view. This result seems to be quite against the arguments in IT outsourcing practices in the fields, which emphasize usually the importance of planning and implementation processes upfront in IT outsourcing projects. According to after-the-fact observation by an expert in an organization participating in the study, their needs and motivations for outsourcing contracts had been quite familiar already to the vendors as long-term partners under a same conglomerate, so that the maturity in the phases of planning and implementation seems not to be differentiating factors for the success of IT outsourcing. This study will be the foundation for the future research in the area of IT outsourcing management and success, in particular in the service level management. And also, it could guide managers in practice in IT outsourcing management to focus on service level management process in operation and evaluation stage especially for long-term outsourcing contracts under very unique context like Korean IT outsourcing projects. This study has some limitations in generalization because the sample size is small and the context itself is confined in an unique environment. For future exploration, survey based research could be designed and implemented.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.24 no.1
• /
• pp.20-26
• /
• 2020

Purpose It is intended to figure out the errors derived from changes in depth and volume when measuring the Standard source and ^99mTc-pertechnetate by using a Dose calibrator. Then recommend appropriate measurement depth and volume. Materials and Methods As a Dose calibrator, CRC-15βeta and CRC-15R (Capintec, New Jersey, USA) was used, and the measurement sources were ⁵⁷Co, ¹³³Ba, ¹³⁷Cs and ^99mTc-pertechnetate was also adopted due to its high frequency of use. The Standard source was respectively measured the changes according to its depth without changing the volume, in a range of 0 cm to 15 cm from the bottom of the ion chamber. ^99mTc-pertechnetate was measured at each depth by changing the volume with 0.1 mL, 0.3 mL, 0.5 mL, 0.7 mL and 0.9 mL Respectively. And the depth range was from 0 cm to 15 cm at the bottom of the ion chamber. Results In the case of Standard source ⁵⁷Co, ¹³³Ba, ¹³⁷Cs and ^99mTc-pertechnetate, there were significant differences according to the measurement depth(p<0.05). ^99mTc-pertechnetate has a negative correlation coefficient according to the depth, and the error of the measured value was negligible at a depth from 0 cm to 7 cm at 0.3 mL and 0.5 mL, and the range of error increased as the volume increased. Conclusion In clinical practice, it is sometimes installed differently than the Standard depth recommended by the equipment company. If it's measured at the recommended depth and volume, it could be thought that unnecessary exposure of the operator and the patient will be reduced, and more accurate radiation exams will be possible in quantitative analysis.