• Quality Improvement in Health Care
• /
• v.7 no.2
• /
• pp.204-216
• /
• 2000

Background : There has been a concern that the quality of care provided to end-stage renal disease (ESRD) patients in the United States may not be as good as recommended. This paper illustrates a composite measure to assess, the quality of care received by ESRD patients undergoing in-center hemodialysis by incorporating outcomes for 4 major treatment areas. The 4 treatment areas are: dialysis treatments, anemia control, nutritional management, and blood pressure control. Methods : The major data source for the study was the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave 1 (DMMS-1) d Sixteen categories of a composite quality indicator were constructed by combining 4 dichotomous variables (16=2*2*2*2). representing the optimal vs. less than optimal level of outcome for each of the 4 treatment outcome measure respectively. Optimal outcome level for each treatment area was defined based on the recommendation from the National Kidney Foundation: (a) delivered dialysis doses (Kt/V) ${\geq}$ 1.2; (b) hematocrit level ${\geq}$ 30%; (c) serum albumin concentration ${\geq}$ 3.8g/dl ; and (d) blood pressure of <140 / <90mmHg. The 16 quality indicator were ranked according to their relative quality weights, which were estimated from its association with the relative risk of survival, adjusting for patient's baseline severity and dialysis facility characteristics. Results : Out of the entire sample of 2,179 patients, only 229 (10%) meet th recommended outcome levels for all 4 treatment areas. Overall, the study patients were distributed evenly over the 16 quality indicators, indicating a great variation in the quality of ESRD care. It appears that the rank of the 16 quality-indicators is driven by serum albumin concentration, suggesting that serum albumin concentration may be the most powerful predictor of ESRD patient survival among the 4 outcome measures. Conclusion : The developed quality indicator has the advantage of describin a range of care for dialysis patients and thus providing a more complete picture of care as compared to previous studies that have focused on only single or few components of the ESRD care.

• Journal of Korean Neurosurgical Society
• /
• v.57 no.1
• /
• pp.1-5
• /
• 2015

Objective : Cerebral vessels, such as intracerebral perforating arterioles isolated from rat brain, have been widely used as an ex vivo model to study the cerebrovascular function associated with cerebrovascular disorders and the therapeutic effects of various pharmacological agents. These perforating arterioles, however, have demonstrated differences in the vascular architecture and reactivity compared with a larger leptomeningeal artery which has been commonly implicated in cerebrovascular disease. In this study, therefore, we developed the method for studying cerebrovascular function utilizing the olfactory artery isolated from the mouse brain. Methods : The olfactory artery (OA) was isolated from the C57/BL6 wild-type mouse brain. After removing connective tissues, one side of the isolated vessel segment (approximately $-500{\mu}m$ in length) was cannulated and the opposite end of the vessel was completely sealed while being viewed with an inverted microscope. After verifying the absence of pressure leakage, we examined the vascular reactivity to various vasoactive agents under the fixed intravascular pressure (60 mm Hg). Results : We found that the isolated mouse OAs were able to constrict in response to vasoconstrictors, including KCl, phenylephrine, endothelin-1, and prostaglandin $PGH_2$. Moreover, this isolated vessel demonstrated vasodilation in a dose-dependent manner when vasodilatory agents, acetylcholine and bradykinin, were applied. Conclusion : Our findings suggest that the isolated olfactory artery would provide as a useful ex vivo model to study the molecular and cellular mechanisms of vascular function underlying cerebrovascular disorders and the direct effects of such disease-modifying pathways on cerebrovascular function utilizing pharmacological agents and genetically modified mouse models.

• Journal of Chest Surgery
• /
• v.24 no.3
• /
• pp.310-321
• /
• 1991

Between April 1986 and September 1990, 34 patients with a single or dominant right ventricle underwent modified Fontan procedure for definite palliation in Seoul National University Children`s Hospital. Their age at operation ranged from 8 months to 14 years [Mean 5.5 years]. The ventricular chamber was solitary and of indeterminate trabecular pattern in 6 patients. 28 patients had posteriorly located rudimentary chamber, all of which were trabecular pouches having no communication with outlet septum. The patterns of atrioventricular connection were common inlet[9], double inlet [11], left atrioventricular valve atresia [12] and right atrioventricular valve atresia with L-loop [2]. Pulmonary outflow tracts were atretic in 7 patients and stenotic in 26 patients. Major associated anomalies included anomalous systemic venous drainage [15], dextrocardia [12] and total anomalous pulmonary venous connection[3]. Shunt operations were previously performed in 13 patients and pulmonary artery banding and atrial septectomy in 1 patients. Surgery included intraatrial baffling in 26 patients, bidirectional cavopulmonary shunt in 13 patients, atrioventricular valve obliteration in 3 patients and atrioventricular valve replacement in 3 patients. Central venous pressure measured postoperatively at intensive care unit ranged from 18cm H2O to 28cm H2O [mean 23.2cm H2O]. Hospital mortality was 35.3% [12/34], all died out of low output syndrome. Suspected causes of low output syndrome include ventricular dysfunction [8], hypoplastic or tortuous pulmonary artery [2] and elevated pulmonary vascular resistance [2]. 19 patients had 31 major complications including low output syndrome [18], arrhythmia [4], acute renal failure [3] and respiratory failure [3]. Mortality rate was significantly higher in the groups receiving intraatrial baffling and AV valve replacement respectively [p<0.05]. 20 patients were followed up postoperatively with the mean follow-up period 15.0$\pm$11.6 months. There were no late death and follow-up catheterization was performed in 10 patients. Mean right atrial pressure was 15.4$\pm$6.8mmHg and ventricular contraction was reasonable in all but one case. Thus, Fontan principle can be applied successfully to all the patients with complex cardiac anomaly of single ventricle variety and better results can be anticipated with judicious selection of patient and improvement of postoperative care.

• Proceedings of the Plant Resources Society of Korea Conference
• /
• 2018.10a
• /
• pp.109-109
• /
• 2018

Bacillus subtilis B22, a chemotrophic and aerobic bacterial strain was isolated from homemade kimchi, identified by 16S rRNA gene sequencing. B22 was primarily screened by biochemical, carbon source utilization tests. B22 was used to produce pectinase and ${\beta}$-glucosidase by submerged fermentation under different light sources. B22 was incubated in pectin media and basal media (pH 7.0) under blue, green, red and white light-emitting diodes (LEDs), fluorescent white light, and in darkness at $37^{\circ}C$, orbital shaker 150 rpm for 24 hours. Fermentation under blue LEDs maximized pectinase production ($71.59{\pm}1.6U/mL$ at 24 h) and ${\beta}$-glucosidase production ($56.31{\pm}1.6U/mL$ at 24 h). Further, the production of enzyme increased to pectinase ($156{\pm}1.28U/mL$) and ${\beta}$-glucosidase ($172{\pm}1.28U/mL$) with 3% glucose as a carbon source. Activity and stability of the partially purified enzymes were higher at pH 6.0 to 8.0 and $25-55^{\circ}C$. The effect on the metal ions $Na^+$ and $K^+$ and (moderateactivity) $Mn^{2+}$ and $Ni^{2+}$ increased activity, while $Hg^{2+}$, $Cu^{2+}$, $Fe^{2+}$, and $Fe^{2+}$ inhibited activity. EDTA, phenylmethylsulfonyl fluoride and 5,5-dithiobis (2-nitrobenzoicacid) reduced activity, while tetrafluoroethylene and 1,10-phenanthroline inhibited activity. The amylase was highly tolerant of the surfactants TritonX-100, Tween-20, Tween-80 and compatible with organic solvents methanol, ethanol, isoamylalcohol, isopropanol, t-butylalcohol and the oxidizing agents hydrogen peroxide, sodium perborate and sodium hypochlorite, although potassium iodide and ammonium persulfate reduced activity. These properties suggest utility of pectinase and ${\beta}$-glucosidase produced by B. subtilis B22 under blue LED-mediated fermentation for industrial applications.

• Membrane Journal
• /
• v.14 no.2
• /
• pp.99-107
• /
• 2004

Carbon molecular sieve (CMS) membranes were prepared by pyrolysis of polyimides having carboxylic acid groups and applied to the hydrogen separation. The polymeric membranes having carboxylic acid groups showed different steric properties as compared with polymeric membranes having other side groups ($-CH_3$ and $-CF_3$) because of the hydrogen bond between the carboxylic acid groups. However, the microporous CMS membranes were significantly affected by the decomposable side groups evidenced from the wide angle X-rat diffraction, nitrogen adsorption isotherms, and single gas permeation measurement. Furthermore, the gas separation properties of the CMS membranes were essentially affected by the pyrolysis temperature. As a result, the CMS membranes Prepared by Pyrolysis of polyimide containing carboxylic acid froups at $700^{\circ}C$ showed the $H_2$ permeability of 3,809 Baller [$1{\times}10^{-10}$ H $\textrm{cm}^$(STP)cm/$\textrm{cm}^2$.s.cmHg], $H_2$/$N_2$, selectivity of 46 and $H_2$/$CH_4$ selectivity of 130 while the CMS membranes derived from polyimide showed the H$_2$ permeability of 3,272 Barrer, $H_2$/$N_2$ selectivity of 136 and $H_2$/$CH_4$ selectivity of 177.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.10
• /
• pp.4217-4224
• /
• 2014

Cholangiocarcinoma (CCA), a slow growing but highly metastatic tumor, is highly prevalent in Northeast Thailand. Specific tests that predict prognosis of CCA remain elusive. The present study was designed to investigate whether peripheral blood leukocyte (PBL) transcriptional profiles might be of use as a prognostic test in CCA patients. Gene expression profiles of PBLs from 9 CCA and 8 healthy subjects were conducted using the Affymetrix HG_U133 Plus 2.0 GeneChip. We indentified informative PBLs gene expression profiles that could reliably distinguish CCA patients from healthy subjects. Of these CCA specific genes, 117 genes were up regulated and 60 were down regulated. The molecular and cellular functions predicted for these CCA specific genes according to the Gene Ontology database indicated differential PBL expression of host immune response and tumor progression genes (EREG, TGF ${\beta}1$, CXCL2, CXCL3, IL-8, and VEGFA). The expression levels of 9 differentially expressed genes were verified in 36 CCA vs 20 healthy subjects. A set of three tumor invasion related genes (PLAU, CTSL and SERPINB2) computed as "prognostic index" was found to be an independent and statistically significant predictor for CCA patient survival. The present study shows that CCA PBLs may serve as disease predictive clinically accessible surrogates for indentifying expressed genes reflective of CCA disease severity.

• Journal of Environmental Science International
• /
• v.16 no.12
• /
• pp.1337-1343
• /
• 2007

The aim of this study was to isolate chicken feather-degrading bacteria with high keratinolytic activity and to investigate cultural conditions affecting keratinolytic enzyme production by a selected isolate. A chicken feather-degrading bacterial strain CH3 was isolated from poultry wastes. Isolate CH3 degraded whole chicken feather completely within 3 days. On the basis of phenotypical and 16S rDNA studies, isolate CH3 was identified as Bacillus thuringiensis CH3. This strain is the first B. thuringiensis described as a feather degrader. The bacterium grew with an optimum at pH 8.0 and $37^{\circ}C$, where maximum keratinolytic activity was also observed. The composition of optimal medium for keratinolytic enzyme production was feather 0.1%, sucrose 0.7%, casein 0.3%, $K_2HPO_4$ 0.03%, $KH_2PO_4$ 0.04%, $MgCl_2$ 0.01% and NaCl 0.05%, respectively. The keratinolytic enzyme had a pH and temperature optima 9.0 and $45^{\circ}C$, respectively. The keratinolytic activity was inhibited ethylenediaminetetraacetic acid, phenylmethylsulfonyl fluoride, and metal ions like $Hg^{2+},\;Cu^{2+}\;and\;Zn^{2+}$. The enzyme activated by $Fe^{2+}$, dithiothreitol and 2-mercaptoethanol.

• Journal of the Korea Fashion and Costume Design Association
• /
• v.10 no.3
• /
• pp.173-180
• /
• 2008

Cotton, wool, cotton/wool blended (80:20) and tencel fabrics were treated with low temperature oxygen plasma, enzymes (cellulase or protease), or oxygen plasma-enzyme and they were examined for dyeing and handling properties for environment friendly finishing. The appropriate conditions for cellulase treatment were enzyme concentration of 3g/l, pH of 5, and $60^{\circ}C$ for one hour, and for protease treatment were enzyme concentration of 4g/l, pH of 8, and $60^{\circ}C$ for one hour. The equilibrium uptake of a direct dye on cotton changed with plasma treatment and plasma-cellulase treatment, and the rate of dyeing slightly decreased. When wool was dyed with acid dye, the equilibrium dye uptake did not change with plasma, protease treatment nor plasma-protease treatment, however, the rate of dyeing had increased with plasma-protease treatment. From these results, it is assumed that plasma attacks the surface of the fiber, and enzyme mainly affects the inner part of the fiber. Plasma treatment did not affect mechanical properties related to the handling of fabrics. The handling test showed increased extension at maxmum load(EM), tensile energy(WT) with decreased tensile resilience (RT), and the fabrics became softer but resilience decreased slightly with enzyme treatment. The bending recidity(B), hysteresis of bending moment(2HB), and hysteresis of shear force at five degrees(2HG5) decreased, however, shear stiffness(G) increased. I knew the plasma pre-treatment made fabrics softer with lower koshi(stiffness). The handling of plasma pre-treated fabrics was better than that of enzyme-treated fabrics. When we pre-treated fabrics, the handling test showed decreased coefficient of friction(MIU), geometrical roughness(SMD), while the surface of fabrics became smoother and numeri increased. Even though compression resilience(RC) increased, fukurami(bulky property) and compressive elasticity, decreased due to the linearity of compression-thickness curve(LC) and compression energy(WC).

• Journal of the Korean Home Economics Association
• /
• v.44 no.10
• /
• pp.57-66
• /
• 2006

The purpose of this study was to evaluate the relationship between the tactile sensation and mechanical properties of towel. Six kinds of towels with different surface structure and fiber composition were used for this study. To evaluate the tactility of towel, 36 adjectives were collected and then 11 adjectives were selected. The subjective evaluation was examined by one to one comparative method and by blind test for estimating the only the sense of touch of the towels. Kawabata's Evaluation system for fabrics was used to measure the mechanical properties which are tensile, bending, shear, compression, surface, weight, and thickness of six towels. The results are as follows; First, surface structure of the towels had an effect on estimation the sense of touch. Pile surface was evaluated thicker, compacter, more cushiony, and more elastic. Waffle surface was evaluated knottier and rougher, and microfiber suede surface was evaluated softer and denser. Second, the highest value of the mechanical properties measured were G, 2HG, B, and SMD of 100% cotton 100% pile, WC, T, and W of elban loop pile, WT, 2HB, and LC of 100% cotton cut pile, RT and MIU of microfiber suede, and RC of microfiber waffle. Third, the 11 adjectives were correlated with more than one mechanical property. 'Knotty' and 'rough' were correlated with MMD and SMD, 'soft' were correlated with B, 2HB, MMD, and SMD. 'Thick', 'heavy', 'compact', and 'elastic' were correlated with WC, T, and W, 'cushiony' was correlated with WC. 'Stiff' was correlated with B and 2HB, 'dry out' was correlated with RT, WC, MIU, and T. 'Dense' was correlated with RT and SMD.

• Journal of Trauma and Injury
• /
• v.30 no.4
• /
• pp.238-241
• /
• 2017

A 52-year-old man experienced blunt trauma upon falling from a height of 40 m while trying to repair the elevator. The patient's systolic blood pressure and hemoglobin levels were 60 mmHg and 7.0 g/dL, respectively, upon admission. A large volume of bloody discharge was observed in the open wound of the perianal area and sacrum. A computed tomography scan revealed an open comminuted sacral fracture with multiple contrast blushes. He underwent emergency laparotomy. Both internal iliac artery ligations were performed to control bleeding from the pelvis. Protective sigmoid loop colostomy was performed because of massive injury to the anal sphincters and pelvis. Pad packing was performed for a sacral open wound and perineal wound at the prone position. After resuscitation of massive transfusion, he underwent the second operation 2 days after the first operation. The pad was removed and the perineal and sacral open wounds were closed. After the damage-control surgery, he recovered safely. In this case, the hemodynamically unstable, open comminuted sacral fracture was treated safely by internal iliac artery ligation with pad packing.