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Use of Noninvasive Mechanical Ventilation in Acute Hypercapnic versus Hypoxic Respiratory Failure (급성 환기부전과 산소화부전에서 비침습적 환기법의 비교)

  • Lee, Sung Soon;Lim, Chae-Man;Kim, Baek-Nam;Koh, Younsuck;Park, Pyung Hwan;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.987-996
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    • 1996
  • Background : We prospectively evaluated the applicability and effect of noninvasive ventilation (NIV) in acute respiratory failure and tried to find out the parameters that could predict successful application of NIV. Methods : Twenty-six out of 106 patients with either acute ventilatory failure (VF: $PaCO_2$ > 43 mm Hg with pH < 7.35) or oxygenation failure (OF: $PaO_2/AO_2$ < 300 mm Hg with $pH{\geq}7.35$) requiring mechanical ventilation were managed by NIV (CPAP + pressure suppon, or BiPAP) with face mask. Eleven out of 19 cases with VF (57.9%) (M : F=7 : $55.4{\pm}14.6$ yrs) and 15 out of 87 cases with OF (17.2%) (M : F=12 : 3, $50.6{\pm}15.6$ yrs) were s uilable for NIY. Respiratory rates, arterial blood gases and success rate of NIV were analyzed in each group. Results: 81.8% (9/11) of YF and 40% (6/15) of OF were successfully managed on NIV and were weruled from mechanical ventilator without resorting to endotracheal intubation. Complications were noted in 2 cases (nasal skin necrosis 1, gaseous gastric distension 1). In NIV for ventilatory failure, the respiration rate was significantly decreased at 12 hour of NIV ($34{\pm}9$ /min pre-NIV, $26{\pm}6$ /min at 12 hour of NIV, p=0.045), while $PaCO_2$ ($87.3{\pm}20.6$ mm Hg pre-NIV, $81.2{\pm}9.1$ mm Hg at 24 hour of NIV) and pH ($7.26{\pm}0.04$, $7.32{\pm}0.02$, respectively, p <0.05) were both significantly decreased at 24 hour of NIV In NIV for oxygenation failure, $PaCO_2$ were not different between the successful and the failed cases at pre-NIV and till 12 hours after NIV. The $PaO_2/FIO_2$ ratio, however, significantly improved at 0.5 hour of NIV in successful cases and were maintained at around 200 mm Hg (n=6 : at baseline, 0.5h, 6h, 12h : $120.0{\pm}19.6$, $218.9{\pm}98.3$, $191.3{\pm}55.2$, $232.8{\pm}17.6$ mm Hg, respectively, p=0.0211), but it did not rise in the failed cases (n=9 : $127.9{\pm}63.0$, $116.8{\pm}24.4$, $100.6{\pm}34.6$, $129.8{\pm}50.3$ mm Hg, respectively, p=0.5319). Conclusion : From the above results we conclude that NIV is effective for hypercapnic respiratory failure and its success was heralded by reduction of respiration rale before the reduction in $PaCO_2$ level. In hypoxic respiratory failure, NIV is much less effective, and the immediate improvement of $PaO_2/FIO_2$ ratio at 0.5h after application is thought to be a predictor of successful NIV.

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Stock Identification of Todarodes pacificus in Northwest Pacific (북서태평양에 서식하는 살오징어(Todarodes pacificus) 계군 분석에 대한 고찰)

  • Kim, Jeong-Yun;Moon, Chang-Ho;Yoon, Moon-Geun;Kang, Chang-Keun;Kim, Kyung-Ryul;Na, Taehee;Choy, Eun Jung;Lee, Chung Il
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.17 no.4
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    • pp.292-302
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    • 2012
  • This paper reviews comparison analysis of current and latest application for stock identification methods of Todarodes pacificus, and the pros and cons of each method and consideration of how to compensate for each other. Todarodes pacificus which migrates wide areas in western North Pacific is important fishery resource ecologically and commercially. Todarodes pacificus is also considered as 'biological indicator' of ocean environmental changes. And changes in its short and long term catch and distribution area occur along with environmental changes. For example, while the catch of pollack, a cold water fish, has dramatically decreased until today after the climate regime shift in 1987/1988, the catch of Todarodes pacificus has been dramatically increased. Regarding the decrease in pollack catch, overfishing and climate changes were considered as the main causes, but there has been no definite reason until today. One of the reasons why there is no definite answer is related with no proper analysis about ecological and environmental aspects based on stock identification. Subpopulation is a group sharing the same gene pool through sexual reproduction process within limited boundaries having similar ecological characteristics. Each individual with same stock might be affected by different environment in temporal and spatial during the process of spawning, recruitment and then reproduction. Thereby, accurate stock analysis about the species can play an efficient alternative to comply with effective resource management and rapid changes. Four main stock analysis were applied to Todarodes pacificus: Morphologic Method, Ecological Method, Tagging Method, Genetic Method. Ecological method is studies for analysis of differences in spawning grounds by analysing the individual ecological change, distribution, migration status, parasitic state of parasite, kinds of parasite and parasite infection rate etc. Currently the method has been studying lively can identify the group in the similar environment. However It is difficult to know to identify the same genetic group in each other. Tagging Method is direct method. It can analyse cohort's migration, distribution and location of spawning, but it is very difficult to recapture tagged squids and hard to tag juveniles. Genetic method, which is for useful fishery resource stock analysis has provided the basic information regarding resource management study. Genetic method for stock analysis is determined according to markers' sensitivity and need to select high multiform of genetic markers. For stock identification, isozyme multiform has been used for genetic markers. Recently there is increase in use of makers with high range variability among DNA sequencing like mitochondria, microsatellite. Even the current morphologic method, tagging method and ecological method played important rolls through finding Todarodes pacificus' life cycle, migration route and changes in spawning grounds, it is still difficult to analyze the stock of Todarodes pacificus as those are distributed in difference seas. Lately, by taking advantages of each stock analysis method, more complicated method is being applied. If based on such analysis and genetic method for improvement are played, there will be much advance in management system for the resource fluctuation of Todarodes pacificus.

A Study on Risk Parity Asset Allocation Model with XGBoos (XGBoost를 활용한 리스크패리티 자산배분 모형에 관한 연구)

  • Kim, Younghoon;Choi, HeungSik;Kim, SunWoong
    • Journal of Intelligence and Information Systems
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    • v.26 no.1
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    • pp.135-149
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    • 2020
  • Artificial intelligences are changing world. Financial market is also not an exception. Robo-Advisor is actively being developed, making up the weakness of traditional asset allocation methods and replacing the parts that are difficult for the traditional methods. It makes automated investment decisions with artificial intelligence algorithms and is used with various asset allocation models such as mean-variance model, Black-Litterman model and risk parity model. Risk parity model is a typical risk-based asset allocation model which is focused on the volatility of assets. It avoids investment risk structurally. So it has stability in the management of large size fund and it has been widely used in financial field. XGBoost model is a parallel tree-boosting method. It is an optimized gradient boosting model designed to be highly efficient and flexible. It not only makes billions of examples in limited memory environments but is also very fast to learn compared to traditional boosting methods. It is frequently used in various fields of data analysis and has a lot of advantages. So in this study, we propose a new asset allocation model that combines risk parity model and XGBoost machine learning model. This model uses XGBoost to predict the risk of assets and applies the predictive risk to the process of covariance estimation. There are estimated errors between the estimation period and the actual investment period because the optimized asset allocation model estimates the proportion of investments based on historical data. these estimated errors adversely affect the optimized portfolio performance. This study aims to improve the stability and portfolio performance of the model by predicting the volatility of the next investment period and reducing estimated errors of optimized asset allocation model. As a result, it narrows the gap between theory and practice and proposes a more advanced asset allocation model. In this study, we used the Korean stock market price data for a total of 17 years from 2003 to 2019 for the empirical test of the suggested model. The data sets are specifically composed of energy, finance, IT, industrial, material, telecommunication, utility, consumer, health care and staple sectors. We accumulated the value of prediction using moving-window method by 1,000 in-sample and 20 out-of-sample, so we produced a total of 154 rebalancing back-testing results. We analyzed portfolio performance in terms of cumulative rate of return and got a lot of sample data because of long period results. Comparing with traditional risk parity model, this experiment recorded improvements in both cumulative yield and reduction of estimated errors. The total cumulative return is 45.748%, about 5% higher than that of risk parity model and also the estimated errors are reduced in 9 out of 10 industry sectors. The reduction of estimated errors increases stability of the model and makes it easy to apply in practical investment. The results of the experiment showed improvement of portfolio performance by reducing the estimated errors of the optimized asset allocation model. Many financial models and asset allocation models are limited in practical investment because of the most fundamental question of whether the past characteristics of assets will continue into the future in the changing financial market. However, this study not only takes advantage of traditional asset allocation models, but also supplements the limitations of traditional methods and increases stability by predicting the risks of assets with the latest algorithm. There are various studies on parametric estimation methods to reduce the estimated errors in the portfolio optimization. We also suggested a new method to reduce estimated errors in optimized asset allocation model using machine learning. So this study is meaningful in that it proposes an advanced artificial intelligence asset allocation model for the fast-developing financial markets.

The Effects of the Computer Aided Innovation Capabilities on the R&D Capabilities: Focusing on the SMEs of Korea (Computer Aided Innovation 역량이 연구개발역량에 미치는 효과: 국내 중소기업을 대상으로)

  • Shim, Jae Eok;Byeon, Moo Jang;Moon, Hyo Gon;Oh, Jay In
    • Asia pacific journal of information systems
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    • v.23 no.3
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    • pp.25-53
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    • 2013
  • This study analyzes the effect of Computer Aided Innovation (CAI) to improve R&D Capabilities empirically. Survey was distributed by e-mail and Google Docs, targeting CTO of 235 SMEs. 142 surveys were returned back (rate of return 60.4%) from companies. Survey results from 119 companies (83.8%) which are effective samples except no-response, insincere response, estimated value, etc. were used for statistics analysis. Companies with less than 50billion KRW sales of entire researched companies occupy 76.5% in terms of sample traits. Companies with less than 300 employees occupy 83.2%. In terms of the type of company business Partners (called 'partners with big companies' hereunder) who work with big companies for business occupy 68.1%. SMEs based on their own business (called 'independent small companies') appear to occupy 31.9%. The present status of holding IT system according to traits of company business was classified into partners with big companies versus independent SMEs. The present status of ERP is 18.5% to 34.5%. QMS is 11.8% to 9.2%. And PLM (Product Life-cycle Management) is 6.7% to 2.5%. The holding of 3D CAD is 47.1% to 21%. IT system-holding and its application of independent SMEs seemed very vulnerable, compared with partner companies of big companies. This study is comprised of IT infra and IT Utilization as CAI capacity factors which are independent variables. factors of R&D capabilities which are independent variables are organization capability, process capability, HR capability, technology-accumulating capability, and internal/external collaboration capability. The highest average value of variables was 4.24 in organization capability 2. The lowest average value was 3.01 in IT infra which makes users access to data and information in other areas and use them with ease when required during new product development. It seems that the inferior environment of IT infra of general SMEs is reflected in CAI itself. In order to review the validity used to measure variables, Factors have been analyzed. 7 factors which have over 1.0 pure value of their dependent and independent variables were extracted. These factors appear to explain 71.167% in total of total variances. From the result of factor analysis about measurable variables in this study, reliability of each item was checked by Cronbach's Alpha coefficient. All measurable factors at least over 0.611 seemed to acquire reliability. Next, correlation has been done to explain certain phenomenon by correlation analysis between variables. As R&D capabilities factors which are arranged as dependent variables, organization capability, process capability, HR capability, technology-accumulating capability, and internal/external collaboration capability turned out that they acquire significant correlation at 99% reliability level in all variables of IT infra and IT Utilization which are independent variables. In addition, correlation coefficient between each factor is less than 0.8, which proves that the validity of this study judgement has been acquired. The pair with the highest coefficient had 0.628 for IT utilization and technology-accumulating capability. Regression model which can estimate independent variables was used in this study under the hypothesis that there is linear relation between independent variables and dependent variables so as to identify CAI capability's impact factors on R&D. The total explanations of IT infra among CAI capability for independent variables such as organization capability, process capability, human resources capability, technology-accumulating capability, and collaboration capability are 10.3%, 7%, 11.9%, 30.9%, and 10.5% respectively. IT Utilization exposes comprehensively low explanatory capability with 12.4%, 5.9%, 11.1%, 38.9%, and 13.4% for organization capability, process capability, human resources capability, technology-accumulating capability, and collaboration capability respectively. However, both factors of independent variables expose very high explanatory capability relatively for technology-accumulating capability among independent variable. Regression formula which is comprised of independent variables and dependent variables are all significant (P<0.005). The suitability of regression model seems high. When the results of test for dependent variables and independent variables are estimated, the hypothesis of 10 different factors appeared all significant in regression analysis model coefficient (P<0.01) which is estimated to affect in the hypothesis. As a result of liner regression analysis between two independent variables drawn by influence factor analysis for R&D capability and R&D capability. IT infra and IT Utilization which are CAI capability factors has positive correlation to organization capability, process capability, human resources capability, technology-accumulating capability, and collaboration capability with inside and outside which are dependent variables, R&D capability factors. It was identified as a significant factor which affects R&D capability. However, considering adjustable variables, a big gap is found, compared to entire company. First of all, in case of partner companies with big companies, in IT infra as CAI capability, organization capability, process capability, human resources capability, and technology capability out of R&D capacities seems to have positive correlation. However, collaboration capability appeared insignificance. IT utilization which is a CAI capability factor seemed to have positive relation to organization capability, process capability, human resources capability, and internal/external collaboration capability just as those of entire companies. Next, by analyzing independent types of SMEs as an adjustable variable, very different results were found from those of entire companies or partner companies with big companies. First of all, all factors in IT infra except technology-accumulating capability were rejected. IT utilization was rejected except technology-accumulating capability and collaboration capability. Comprehending the above adjustable variables, the following results were drawn in this study. First, in case of big companies or partner companies with big companies, IT infra and IT utilization affect improving R&D Capabilities positively. It was because most of big companies encourage innovation by using IT utilization and IT infra building over certain level to their partner companies. Second, in all companies, IT infra and IT utilization as CAI capability affect improving technology-accumulating capability positively at least as R&D capability factor. The most of factor explanation is low at around 10%. However, technology-accumulating capability is rather high around 25.6% to 38.4%. It was found that CAI capability contributes to technology-accumulating capability highly. Companies shouldn't consider IT infra and IT utilization as a simple product developing tool in R&D section. However, they have to consider to use them as a management innovating strategy tool which proceeds entire-company management innovation centered in new product development. Not only the improvement of technology-accumulating capability in department of R&D. Centered in new product development, it has to be used as original management innovative strategy which proceeds entire company management innovation. It suggests that it can be a method to improve technology-accumulating capability in R&D section and Dynamic capability to acquire sustainable competitive advantage.

Surgical Treatment of Anomalous Origin of Coronary Artery from the Pulmonary Artery: Postoperative Changes of Ventricular Dimensions and Mitral Regurgitation (관상동맥-폐동맥 이상기시증(Anomalous Origin of Coronary Artery from Pulmonary Artery)의 수술적 치료: 중기 성적과 좌심실 및 승모판 기능의 변화 양상에 대한 연구)

  • Kang, Chang-Hyun;Kim, Woong-Han;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Back, Man-Jong;Oh, Sam-Se;Na, Chan-Young;Han, Jae-Jin;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.19-26
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    • 2004
  • Background: The aims of this study are to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR), Material and Method: Fifteen patients operated on since 1985 were included in the study. The patients operated on before 1998 (n=9) showed heterogeneous properties with various surgical strategies and cardiopulmonary bypass techniques. However, six patients were operated on with the established surgical strategy since 1998; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery, 2) Coronary transfer by rolled-conduit made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not peformed. Result: Median age of the study group was 6 months (1 month to 34 years). The operative methods were left subclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 patients. The mean follow up period was 5.5<5.8 years (2 months 14 years), There were one early death (6.7%) and one late death. Overall 5-year survival rate was 85.6$\pm$9.6%. The Z-value of left ventricular end-diastolic and end-systolic dimensions were 6.4$\pm$3.0 and 5.1 $\pm$3.6 preoperatively, and decreased to 1.7$\pm$ 1.9 and 0.8$\pm$ 1.6 in 3 months (p<0.05). Significant preoperative MR was identified in 6 patients (40%) and all the patients showed immediate improvement of MR within f month postoperatively. There were 3 cases of reoperation due to coronary anastomosis site stenosis and recurrence of MR. However, there was no mortality nor late reoperation in the patients operated on after 1998. Conclusion: The surgical treatment of ALCAPA showed favorable survival and early recovery of ventricular dimensions and mitral valvular function. Although long-term reintervention was required in some cases of earlier period, all the cases after 1998 showed excellent surgical outcome without long-term problem.

The Role of Postoperative Adjuvant Radiotherapy in Resected Esophageal Cancer (식도암에서 근치적 절제술 후 방사선치료의 역할)

  • Lee Chang Geol;Kim Choong Bae;Chung Kyung Young;Lee Doo Yun;Seong Jinsil;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.20 no.4
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    • pp.316-322
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    • 2002
  • Objective : A retrospective study was peformed to evaluate whether postoperative adjuvant radiotherapy can improve survival and decrease recurrence as compared with surgery alone in resected esophageal cancer. Materials and Methods : From Jan. 1985 to Dec. 1993, among 94 esophageal cancer Patients treated with surgery, fifty-one patients were included in this study. Transthoracic esophagectomy was peformed in 35 patients and transhiatal esophagectomy in 16. Postoperative adjuvant radiotherapy was peformed 4 weeks after surgery in 26 among 38 patients in stage II and III. A total dose of $30\~60\;Gy$ in 1.8 Gy daily fraction, median 54 Gy over 6 weeks, was delivered in the mediastinum+both supraclavicular lymph nodes or celiac lymph nodes according to the tumor location. Forty-seven patients$(92\%)$ had squamous histology. The median follow-up period was 38 months. Results : The overall 2-year and 5-year survival and median survival were $56.4\%,\;36.8\%$ and 45 months. Two-year and 5-year survival and median survival by stage were $92\%,\;60.3\%$ for stage I, $63\%,\;42\%$ and 51 months for stage II and $34\%,\;23\%$ and 19 months for stage III (p=0.04). For stage II and III patients, 5-year survival and median survival were $22.8\%$, 45 months for the surgery alone group and $37.8\%$, 22 months for the postoperative RT group (p=0.89). For stage III patients, 2-year survival and median survival were $0\%$, 11 months for the surgery alone group and $36.5\%$, 20 months for the postoperative RT group (p=0.14). Local and distant failure rates for stage II and III were $50\%,\;16\%$ for the surgery alone and $39\%,\;31\%$ for the postoperative RT group. For N1 patients, local failure rate was $71\%$ for the surgery alone group and $37\%$ for the postoperative RT group (p=0.19). Among 10 local failures in the postoperative RT group, in-field failures were 2, marginal failures 1, out-field 5 and anastomotic site failures 2. Conclusion : There were no statistically significant differences in either the overall survival or the patterns of failure between the surgery alone group and the postoperative RT group for resected stage II and III esophageal cancer. But this study showed a tendency of survival improvement and decrease in local failure when postoperative RT was peformed for stage III or N1 though statistically not significant. To decrease local failure, a more generous radiation field encompassing the supraclavicular, mediastinal, and celiac lymph nodes and anastomotic site in postoperative adjuvant treatment should be considered.

Effects of Blended Essential Oil(CRINA®) Supplementation on the Performance, Nutrient Digestibility, Small Intestinal Microflora and Fatty Acid Composition of Meat in Broiler Chickens (사료중 Blended Essential Oil(CRINA®) 첨가가 육계의 생산성과 영양소 이용률, 소장 내 미생물 균총 및 계육내 지방산 조성에 미치는 영향)

  • Suk, J.C.;Lim , H.S.;Paik, I.K.
    • Journal of Animal Science and Technology
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    • v.45 no.5
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    • pp.777-786
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    • 2003
  • An experiment was conducted to investigate the effects of supplementary Blended essential oil(CRINA$^{\circledR}$) on the performance, nutrient availability, fatty acid composition of leg muscle, small intestinal microflora and blood parameters in broiler chickens. One thousand unsexed day-old broiler chickens were assigned to five treatments : control(T1), 5ppm avilamycin(starter diet) & 5ppm flavomycin(grower diet) T2, 5ppm avilamycin(starter diet) & 50ppm CRINA$^{\circledR}$(grower diet) T3, 50ppm CRINA$^{\circledR}$(starter & grower diet) T4, 50ppm CRINA$^{\circledR}$+ 500ppm lactic acid$^{\circledR}$ (starter & grower diet) T5. Each treatment had four replications of 50 birds each. Growth performance was significantly improved by dietary supplements(T2-T5). There were no significant differences among treatment T2, T3, T4 and T5. Feed intake was not significantly different among treatments. Dietary supplementation of CRINA$^{\circledR}$(T3, T4, T5) resulted in significant(p〈0.05) improvement in feed/gain(F/G) during finishing period (4-5weeks). The birds fed CRINA$^{\circledR}$ supplemented diet(T4) showed significantly(p〈0.05) higher availability of crude fat, methionine and methionine + cystine than those fed antibiotics supplemented diet(T2). Mortality was not significantly affected by treatments. The colony forming unit(CFU) of E.coli in small intestinal content was significantly lower in antibiotics & CRINA$^{\circledR}$(T3) compared to CRINA$^{\circledR}$ treatment(T4)(P〈0.05). CFU of Cl. perfringens was low in CRINA$^{\circledR}$(T4) but not different significantly with other treatments. Serum triglyceride level of birds fed CRINA$^{\circledR}$ + lactic acid diet(T5) was significantly lower(p〈0.05) than those fed antibiotics supplemented diet(T2). Cholesterol level of the birds fed antibiotics(T2) or CRINA$^{\circledR}$ + lactic acid supplemented diet(T5) was significantly higher(p〈0.05) than other treatments. HDL level of birds fed control diet was significantly lower(p〈0.05) than that of others. The levels of serum IgG were not significantly different among treatments. Major fatty acids composition of leg muscle fat was significantly influenced by treatments. Control group showed significantly higher palmitic acid(C$_{16:0}$) and steraric acid(C$_{18:0}$) content than other treatments(p〈0.05). Content of oleic acid(C$_{18:1}$), however, was significantly lower in the control than others treatments. Content of linolenic acid(C$_{18:3}$) was significantly higher in CRINA$^{\circledR}$+ lactic acid(T5) than antibiotics & CRINA$^{\circledR}$(T3) treatments. Total saturated fatty acids content was higher and total unsaturated fatty acids were lower in the leg muscle fat of the control than that of other treatments. It is concluded that CRINA$^{\circledR}$ supplementation improved growth rate and F/G ratio in broilers. The combination of CRINA$^{\circledR}$ with either antibiotics or lactic acid did not show any additive or synergistic effects in broiler chickens .

Effect of Geijibokryunghwan and each constituent herb on inhibition of platelet aggregation (계지복령환(桂枝茯笭丸) 및 그 구성약물(構成藥物)의 혈소판응집억제(血小板凝集抑制)에 관(關)한 연구(硏究))

  • Kim, Jong-Goo;Park, Sun-Dong;Park, Won-Hwan
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.115-129
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    • 2000
  • The cause that the increase of animality fat intakes, under exercise, fatness, adding the stress, advanced age etc., the occurrence rate of the circulation system disease has been increased. And the thrombosis importantly came to the front as the risk factor of these circulation system's disease. Nowadays, the ischemic disease has especially discussed, for example the angina or myocardial infarction, originated in thrombosis that came from the platelet aggregation. In the western medicine, as the cure and prevention, using the aspirin or ticlopidine for platelet aggregation suppressant. But in the , the curing method must be used properly according to the pectoralgia or heartache's kind, state, grade. The platelet do not attache to the normal hemangioendothelial cell. But when it stimulated by endothelium peronia and so on, it attache to the injury endothelium or rise aggregation between the platelet. On this time, it secrete the platelet aggregation inducer as like ADP, thromboxane A2 from the inside of platelet. So it has first defensive function through the aggregation augment that prevent the celerity consumption of blood. But the activation of abnormal platelet occur the platelet grume and thrombogenesis. So it bring up the occlusive angiosis, so to speak, cardiovascular disease, cerebrovascular disease, arterial sclerosis. In oriental medicine, the thrombosis in the category of blood stasis and this blood stasis present the generalise or local blood circulation disturbance that generated by all kinds of pathological fact or blood stream retention accompanying with a series of syndrome. As the syndrome, stabbing pain fixed at certain region, squamous and dry skin, fullness and pain of the chest and hypochondrium, firmness and fullness of the lower abdomen, black stool, dark purple tongue or with ecchymoses and petechiae etc.. has been created. And it becomes the pathopoiesis cause that the convulsion and palpitation, severe palpitatiion, tympanites, the symtom complex with a mass or swelling in the abdomen, insanity, stricken by wind etc.. Moreover, it used the drugs for invigorating blood circulation and eliminating blood stasis or drugs for removing blood stasis for all kinds of syndrome through the blood stasis. And the drugs for activating the blood circulation, such as Salviae Radix, Angelicae Sinensis Radix, Persicae Semen, Achyranthis Radix, Cnidii Rhizoma, Carthami Flos are used for that. And it is used to the herbs of insects that has strong effect about the disintergrating blood stasis such as Hirudo, Scolopendrae Corpus, Buthus, Lumbricus etc.. On this study, It used Geijibokryunghwan(GBH) and the consisting herbs to investigate the influence of platelet aggregation about drugs that used to improvement various symptoms created by the thrombosis in oriental medicine. GBH formula has as formula recorded in the , action of 'eleminating the evil and not impairment of healthy energy' and 'promoting the flow of QI and cold and heat, so used for the expel blood stasis herbs from the ancient. Therefore we investigated the restraint effect of GBH and the consisting herbs about the platelet agregation induced to the ADP, AA or collagen. The conclusion is following. 1. When it added the aggregation inducer after that it added GBH and individual consisting herbs in the PRP, GBH showed the (+) inhibition effect on the platelet aggregation and it showed the (+) inhibition effect in the individual consisting herbs as like Paeoniae Radix and Moutan Cortex Radicis. 2. It showed the (+), (+,++) inhibition effect on the platelet aggregation in Paeoniae Radix Hoelen, Paeoniae Radix Moutan Cortex Radicis, Hoelen Moutan Cortex Radicis etc. 3. In the aggregation inhibition activating on the difference of density, GBH showed strong inhibition effect to the aggregation state induced to collagen, and it showed the inhibition effect in the individual consisting herbs as like Paeoniae Radix and Moutan Cortex Radicis about the aggregation induced by the collagen. 4. It showed the strong inhibition effect about the aggregation induced by the collagen in Paeoniae Radix Hoelen, Paeoniae Radix Moutan Cortex Radicis, Hoelen Moutan Cortex Radicis etc Like this, as confirm GBH and the individual consisting herb's inhibition effect of platelet aggregation, We considerated that GBH and the individual consisting herbs have practical applicational value of clinical trial in the thrombosis caused by platelet aggregation.

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The Effect and Safety of Alveolar Recruitment Maneuver using Pressure-Controlled Ventilation in Acute Lung Injury and Acute Respiratory Distress Syndrome (급성폐손상과 급성호흡곤란증후군 환자에서 압력조절환기법을 이용한 폐포모집술의 효과와 안정성)

  • Chung, Kyung Soo;Park, Byung Hoon;Shin, Sang Yun;Jeon, Han Ho;Park, Seon Cheol;Kang, Shin Myung;Park, Moo Suk;Han, Chang Hoon;Kim, Chong Ju;Lee, Sun Min;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.423-429
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    • 2007
  • Background: Alveolar recruitment (RM) is one of the primary goals of respiratory care for an acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The purposes of alveolar recruitment are an improvement in pulmonary gas exchange and the protection of atelectrauma. This study examined the effect and safety of the alveolar RM using pressure control ventilation (PCV) in early ALI and ARDS patients. Methods: Sixteen patients with early ALI and ARDS who underwent alveolar RM using PCV were enrolled in this study. The patients data were recorded at the baseline, and 20 minutes, and 60 minutes after alveolar RM, and on the next day after the maneuver. Alveolar RM was performed with an inspiratory pressure of $30cmH_2O$ and a PEEP of $20cmH_2O$ in a 2-minute PCV mode. The venous $O_2$ saturation, central venous pressure, blood pressure, pulse rate, $PaO_2/FiO_2$ ratio, PEEP, and chest X-ray findings were obtained before and after alveolar RM. Results: Of the 16 patients, 3 had extra-pulmonary ALI/ARDS and the remaining 13 had pulmonary ALI/ARDS. The mean PEEP was 11.3 mmHg, and the mean $PaO_2/FiO_2$ ratio was 130.3 before RM. The $PaO_2/FiO_2$ ratio increased by 45% after alveolar RM. The $PaO_2/FiO_2$ ratio reached a peak 60 minutes after alveolar RM. The Pa$CO_2$ increased by 51.9 mmHg after alveolar RM. The mean blood pressure was not affected by alveolar RM. There were no complications due to pressure injuries such as a pneumothorax, pneumomediastinum, and subcutaneous emphysema. Conclusion: In this study, alveolar RM using PCV improved the level of oxygenation in patients with an acute lung injury and acute respiratory distress syndrome. Moreover, there were no significant complications due to hemodynamic changes and pressure injuries. Therefore, alveolar RM using PCV can be applied easily and safely in clinical practice with lung protective strategy in early ALI and ARDS patients.

Improvement of Certification Criteria based on Analysis of On-site Investigation of Good Agricultural Practices(GAP) for Ginseng (인삼 GAP 인증기준의 현장실천평가결과 분석에 따른 인증기준 개선방안)

  • Yoon, Deok-Hoon;Nam, Ki-Woong;Oh, Soh-Young;Kim, Ga-Bin
    • Journal of Food Hygiene and Safety
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    • v.34 no.1
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    • pp.40-51
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    • 2019
  • Ginseng has a unique production system that is different from those used for other crops. It is subject to the Ginseng Industry Act., requires a long-term cultivation period of 4-6 years, involves complicated cultivation characteristics whereby ginseng is not produced in a single location, and many ginseng farmers engage in mixed-farming. Therefore, to bring the production of Ginseng in line with GAP standards, it is necessary to better understand the on-site practices of Ginseng farmers according to established control points, and to provide a proper action plan for improving efficiency. Among ginseng farmers in Korea who applied for GAP certification, 77.6% obtained it, which is lower than the 94.1% of farmers who obtained certification for other products. 13.7% of the applicants were judged to be unsuitable during document review due to their use of unregistered pesticides and soil heavy metals. Another 8.7% of applicants failed to obtain certification due to inadequate management results. This is a considerably higher rate of failure than the 5.3% incompatibility of document inspection and 0.6% incompatibility of on-site inspection, which suggests that it is relatively more difficult to obtain GAP certification for ginseng farming than for other crops. Ginseng farmers were given an average of 2.65 points out of 10 essential control points and a total 72 control points, which was slightly lower than the 2.81 points obtained for other crops. In particular, ginseng farmers were given an average of 1.96 points in the evaluation of compliance with the safe use standards for pesticides, which was much lower than the average of 2.95 points for other crops. Therefore, it is necessary to train ginseng farmers to comply with the safe use of pesticides. In the other essential control points, the ginseng farmers were rated at an average of 2.33 points, lower than the 2.58 points given for other crops. Several other areas of compliance in which the ginseng farmers also rated low in comparison to other crops were found. These inclued record keeping over 1 year, record of pesticide use, pesticide storages, posts harvest storage management, hand washing before and after work, hygiene related to work clothing, training of workers safety and hygiene, and written plan of hazard management. Also, among the total 72 control points, there are 12 control points (10 required, 2 recommended) that do not apply to ginseng. Therefore, it is considered inappropriate to conduct an effective evaluation of the ginseng production process based on the existing certification standards. In conclusion, differentiated certification standards are needed to expand GAP certification for ginseng farmers, and it is also necessary to develop programs that can be implemented in a more systematic and field-oriented manner to provide the farmers with proper GAP management education.