• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1200-1206
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• 2003

Purpose : This study was conducted for the use of nasal continuous positive airway pressure (CPAP), by comparing the early use of non-invasive nasal CPAP with low intermittent mandatory ventilation(low IMV) and endotracheal CPAP in weaning a mechanical ventilator from infants with moderate respiratory distress syndrome(RDS). Methods : Thirty infants in the study group, with moderate RDS from November 2001 to June 2002, were administered surfactants and treated with the mechanical ventilator, and applied the nasal CPAP in weaning. Thirty infants of the control group, from January 1999 to September 2001, were applied low IMV and endoctracheal CPAP in weaning. Results : There were no significant differences in the characteristics, the severity of clinical symptoms, the initial laboratory findings and settings of the mechanical ventilator. After weaning, the study group showed no significant changes in $PaCO_2$. However, the control group showed a slight $CO_2$ retension after one and 12 hours. Twenty eight infants(93.3%) of the study group and 24 infants(80%) of the control group were successfully extubated. The primary cause of failure was apnea. There were no significant differences in the duration of weaning and the mechanical ventilator treatment between the groups. Complications in weaning were related to the fixation of nasal CPAP and the mechanical problems caused by endotracheal tube. Conclusion : Aggressive weaning is possible for moderate RDS, in which the nasal CPAP was used without the low IMV and the endotracheal CPAP process. It had no difficulties. In conclusion, the nasal CPAP is an adequate weaning method for moderate RDS.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.1-11
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• 2008

Background: The Damus-Kaye-Stansel (DKS) procedure is a proximal MPA-ascending aorta anastomosis used to relieve systemic ventricular outflow tract obstructions (SVOTO) and pulmonary hypertension. The purpose of this study was to review the indications and outcomes of the DKS procedure, including the DKS pathway and semilunar valve function. Material and Method: A retrospective review of 28 patients who underwent a DKS procedure between May 1994 and April 2006 was performed. The median age at operation was 5.3 months ($13\;days{\sim}38.1\;months$) and body weight was 5.0 kg ($2.9{\sim}13.5\;kg$). Preoperative pressure gradients were $25.3{\pm}15.7\;mmHg$ ($10{\sim}60\;mmHg$). Eighteen patients underwent a preliminary pulmonary artery banding as an initial palliation. Preoperative main diagnoses were double outlet right ventricle in 9 patients, double inlet left ventricle with ventriculoarterial discordance in 6,. another functional univentricular heart in 5, Criss-cross heart in 4, complete atrioventricular septal defect in 3, and hypoplastic left heart variant in 1. DKS techniques included end-to-side anastomosis with patch augmentation in 14 patients, classical end-to-side anastomosis in 6, Lamberti method (double-barrel) in 3, and others in 5. The bidirectional cavopulmonary shunt and Fontan procedure were concomitantly performed in 6 and 2 patients, respectively. Result: There were 4 hospital deaths (14.3%), and 3 late deaths (12.5%) with a follow-up duration of $62.7{\pm}38.9$ months ($3.3{\sim}128.1$ months). Kaplan-Meier estimated actuarial survival was $71.9%{\pm}9.3%$ at 10 years. Multivariate analysis showed right ventricle type single ventricle (hazard ratio=13.960, p=0.004) and the DKS procedure as initial operation (hazard ratio=6.767, p=0.042) as significant mortality risk factors. Four patients underwent staged biventricular repair and 13 received Fontan completion. No SVOTO was detected after the procedure by either cardiac catheterization or echocardiography except in one patient. There was no semiulnar valve regurgitation (>Gr II) or semilunar valve-related reoperation, but one patient (3.6%) who underwent classical end-to-side anastomosis needed reoperation for pulmonary artery stenosis caused by compression of the enlarged DKS pathway. The freedom from reoperation for the DKS pathway and semilunar valve was 87.5% at 10 years after operation. Conclusion: The DKS procedure can improve the management of SVOTO, and facilitate the selected patients who are high risk for biventricular repair just after birth to undergo successful staged biventricular repair. Preliminary pulmonary artery banding is a safe and effective procedure that improves the likelihood of successful DKS by decreasing pulmonary vascular resistance. The long-term outcome of the DKS procedure for semilunar valve function, DKS pathway, and relief of SVOTO is satisfactory.

• Journal of the Korean Society of Clothing and Textiles
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• v.28 no.12 s.138
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• pp.1596-1604
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• 2004

Quality Function Deployment(QFD) is a product development tool which ensures that the voice of the customer needs is heard and translated into products. To develop a sensible brassiere for middle-aged women QFD was adopted. In this study the applicability and usefulness of QFD was examined through the engineering design process for a sensible brassiere for middle-aged women. The customer needs for the wear comfort of brassiere was made by one-on-one survey of 100 women who aged 30-40. The customer competitive assessment was generated by wearing tests of 10 commercial brassieres. The subjective assessment was conducted in the enviornmental chamber that was controlled at $28{\pm}1^{\circ}C,\;65{\pm}3\%RH.$ As a results, we developed twenty-one customer needs and corresponding HOWs for the wear comfort of brassiere. The Customer Competitive Assessment was generated by wearing tests of commercial brassiere. The subjective measurement scale and dimension for the evaluation of sensible brassiere were extracted from factor analysis. Four factors were fitting, aesthetic property, pressure sensation, displacement of brassiere due to movement. The most critical design parameter was wire-related property and second one was stretchability of main material of brassiere. Also, wearing comfort of brassiere was affected by the interaction of initial stretchability of wing and support of strap. Engineering design process, QFD was applicable to the development of technical and aesthetic brassieres.

• The Journal of Engineering Geology
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• v.16 no.1 s.47
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• pp.69-83
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• 2006

This study aims to evaluate a complex groundwater flow system around the underground oil storage caverns using the concept of hydraulic compartment. For the hydrogeological analysis, the hydraulic testing data, the evolution of groundwater levels in 28 surface monitoring boreholes and pressure variation of 95 horizontal and 63 vertical water curtain holes in the caverns were utilized. At the cavern level, the Hydraulic Conductor Domains(fracture zones) are characterized one local major fracture zone(NE-1)and two local fracture zones between the FZ-1 and FZ-2 fracture zones. The Hydraulic Rock Domain(rock mass) is divided into four compartments by the above local fracture zones. Two Hydraulic Rock Domains(A, B) around the FZ-2 zone have a relatively high initial groundwater pressures up to $15kg/cm^2$ and the differences between the upper and lower groundwater levels, measured from the monitoring holes equipped with double completion, are in the range of 10 and 40 m throughout the construction stage, indicating relatively good hydraulic connection between the near surface and bedrock groundwater systems. On the other hand, two Hydraulic Rock Domains(C, D) adjacent to the FZ-1, the groundwater levels in the upper and lower zones are shown a great difference in the maximum of 120 m and the high water levels in the upper groundwater system were not varied during the construction stage. This might be resulted from the very low hydraulic conductivity$(7.2X10^{-10}m/sec)$ in the zone, six times lower than that of Domain C, D. Groundwater recharge rates obtained from the numerical modeling are 2% of the annual mean precipitation(1,356mm/year) for 20 years.

• Economic and Environmental Geology
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• v.38 no.2 s.171
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• pp.187-196
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• 2005

Structural sites which cations can occupy in garnet structure are centers of the tetrahedron, octahedron, and distorted cube sharing edges with the tetrahedron and octahedron. Among them, the size of cation occuping at tetrahedral site (the center of tetrahedron) is closely related with the size of a unit cell of garnet. Accordingly, garnet containing iron with relative large ionic radii in tetrahedral site can be considered as a promising matrix for the immobilization of the elements with large ionic radii, such as actinides in radioactive wastes. We synthesized several garnets with the batch composition of $Ca_{1.5}GdCe_{0.5}ZrFeFe_3O_{12}$, and studied their properties and phase relations under various conditions. Mixed samples were fabricated in a pellet form under a pressure of $200{\~}400{\cal}kg/{\cal}cm^2$ and were sintered in the temperature range of $1100\~1400^{\circ}C$ in air and under oxygen atmospheres. Phase identification and chemical analysis of synthesized samples were conducted by XRD and SEM/EDS. In results, garnet was obtained as the main phase at $1300^{\circ}C$, an optimum condition in this system, even though some minor phases like perovskite and unknown phase were included. The compositions of garnet and perovskite synthesized from the batch composition of $Ca_{1.5}GdCe_{0.5}ZrFeFe_3O_{12}$ were ranged $[Ca_{l.2-1.8}Gd_{0.9-1.4}Ce_{0.3-0.5}]^{VIII}[Zr_{0.8-1.3}Fe_{0.7-1.2}]^{VI}[Fe_{2.9-3.1}]^{IV}O_{12}$ and $Ca_{0.1-0.5}Gd_{0.0-0.8}Ce_{0.1-0.5}\;Zr_{0.0-0.2}Fe_{0.9-1.1}O_3$, respectively. Ca content was exceeded and Ce content was depleted in the 8-coordinated site, comparing to the initial batch composition. This phenomena was closely related to the content of Zr and Fe in the 6-coordinated site.

• Journal of Trauma and Injury
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• v.25 no.2
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• pp.49-56
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• 2012

Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

• Journal of Korean Society of Environmental Engineers
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• v.22 no.12
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• pp.2263-2273
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• 2000

Catalytic wet air oxidation of acetic acid over Mn-Ce based catalysts deposited on various supports ($SiO_2$, $TiO_2$, $ZrO_2$), $ZrSiO_4$, $ZrO_2(10wt%)/TiO_2$) have been carried out in high pressure microreactors. Also, promotional effects by small addition(O.5~1.0 wt%) of p-type semiconductors (CoO, $Ag_2O$, SnO) have been investigated. From the screening tests for initial activity ranking, both Mn(2.8)-Ce(7.2 wt%) and Ru(O.4)Mn(2.7)-Ce(6.9 wt%) supported on $TiO_2$ were selected as the promising reference candidates. In $Mn-Ce/TiO_2$ reference catalyst, addition of small amount of each p-type semiconductor (Co, Sn and Ag) resulted in activity promotional effect and the degree of the increase was in the following order: Co> Ag > Sn. Especially, $Mn-Ce/TiO_2$ promoted with 0.5 wt% Co gave the 2.6 folds activity increase compared to the reference case attributing to the surface area increase as well as synergy effect. In $Ru-Mn-Ce/TiO_2$ reference catalyst, only Co(1.0 wt%) promoted case showed a little reaction rate increase.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.645-653
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• 1999

Introduction : Although myocardial ischemia tends to occur more frequently than can he documented in ventilated patients, it has not been well studied on the factors related to the occurrence of the ischemia. Methods : To investigate the related factors to ischemia development, a prospective study was done in 95 cases with consecutive 73 patients who had received mechanical ventilation(MV) in MICU. In addition to 24 h holter monitoring, echocardiogram, electrolytes, cardiac enzymes, hemodynamic, and gas exchange measurements were done within 24 h after initiation of MV in 69 cases. The measurements were repeated at weaning period in 26 cases. The ischemia was defined by the ST segment changes; up-sloping depression more than 1.5 mm or down-sloping or horizontal depression more than 1.0 mm from isoelectric baseline for 80 ms following J point. Results : Twelve patients(12.6% in 95 cases) developed ischemia in total. The incidence of ischemia development showed an increased tendency in the initial 24 hr after MV (15.9%) and in patients with left-sided heart failure found by echocardiogram (18.2%) compared with that of the weaning period (3.8%) and patients without heart failure (10.9%) (P=0.12, P=0.09, in each). There were no differences in APACHE III score, baseline ECG findings, electrolytes abnormalities, use of inotropics or bronchodilators, presence of sepsis or shock, mode of ventilation, and survival rate according to the development of ischemia. Maximal heart rates and mean arterial pressure also were not different between patients with ($137.2{\pm}30.9/min$, $82.5{\pm}15.9$ mm Hg) and without ischemia ($l29.5{\pm}29.7/min$, $83.8{\pm}17.6$ mm Hg). Conclusion : Although the incidence of myocardial ischemia was 12.6% in total, there were no clinically predictable factors to the development of ischemia during mechanical ventilation.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.2
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• pp.512-519
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• 2009

Among patients who visited each clinical department for oriental medical treatments, anthropometric measurement, blood pressure, fasting blood glucose and blood lipid profile level were measured at their first initial visit. 55 subject patients who were diagnosed as having metabolic syndrome and 150 mg/dL or more of triglyceride were selected as subjects whose fasting blood glucose, triglyceride, total cholesterol, HDL cholesterol and LDL cholesterol were measured after fasting. According to each patient's disease, the subject received treatments such as herb medicine, acupuncture, moxibustion, cupping therapy, physical therapy and rehabilitation therapy from each clinical department, and after an average of 4.10${\pm}$0.31 weeks, another test was performed yielding the following results. Serum triglyceride was 243.72${\pm}$13.05 mg/dL before the oriental medical treatment and 188.11${\pm}$12.17 mg/dL after the treatment where although it continued to show an abnormal value even after the treatment, there was statistically significant decrease compared to pre treatment(P<0.05). Serum total cholesterol was 207.50${\pm}$5.89 mg/dL before the oriental medical treatment and 192.37${\pm}$5.53 mg/dL after the treatment which was statistically insignificant compared to pre treatment(P>0.05). Serum HDL cholesterol was 51.19${\pm}$3.95 mg/dL before the oriental medical treatment and increased to 52.53${\pm}$1.49 mg/dL after the treatment although it was statistically insignificant compared to pre treatment(P>0.05). Serum LDL cholesterol was 110.66${\pm}$5.86 mg/dL before the oriental medical treatment and decreased to 106.12${\pm}$4.82 mg/dL after the treatment although it was statistically insignificant compared to pre treatment(P>0.05). In regards to the change of triglyceride for each sex, it was 221.84${\pm}$14.01 mg/dL before the treatment and 187.00${\pm}$15.47 mg/dL after the treatment for men, and it was 271.50${\pm}$22.78 mg/dL and 189.53${\pm}$19.76 mg/dL respectively for women where even though men and women showed the decrease of 34.84${\pm}$12.79 mg/dL and 81.96${\pm}$20.01 mg/dL respectively, both men and women continue to show abnormal values after the treatments. However, there was statistically significant decrease compared to pre treatment(P<0.05). In regards to the change of total cholesterol for each sex, with 198.24${\pm}$7.60 mg/dL for men before the treatment and 188.93${\pm}$7.45 mg/dL after the treatment, values for both before and after the treatment were within the normal range where the change value was 9.30${\pm}$5.86 mg/dL and statistically insignificant(P>0.05). For women, it was 219.26${\pm}$8.87 mg/dL and 196.73${\pm}$8.43 mg/dL respectively for women where with 22.53${\pm}$7.60 mg/dL, it decreased to the normal level after the treatment, and there was a statistically significant decrease compared to pre treatment(P<0.05). With such results, serum triglyceride and cholesterol levels of patients who have been diagnosed as having metabolic syndrome were observed to decrease after the oriental medical treatment. Especially, for both men and women, abnormally high triglyceride level decreased while the effect of lipid profile improvement for women was more significant compared to men.

• The Journal of the Petrological Society of Korea
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• v.7 no.2
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• pp.77-97
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• 1998

We analyzed geochemical and radiogenic isotope data to investigate the genesis and source characteristics of the Onjeongri granite in the northern part of the Gyeongsang Basin. Field observation and K-Ar ages confirm late Cretaceous intrusion (ca. 87 Ma) of the Onjeongri granite. The hornblende geobarometery gives less than 2 kbar for the emplacement pressure of the Onjeongri granite. Geochemical and isotopic compositions suggest that the Onjeongri granite was formed in a relatively immature arc system. $SiO_2$ contents show a negative linear relationship with initial $^{87}Sr/^{86}Sr$ ratios, and an apparent positive correlation with $^{207}Pb/^{204}Pb$ ratios, suggesting an incomplete mixing or assimilation. However, the isotopic data known for any exposed rocks of the study area do not fit as an endmember, implying that the contaminant might reside in the lower crust. A review of published isotopic ages, geochemical, and Sr and Nd isotopic data for the Cretaceous to Tertiary granites in the Gyeongsang Basin indicates the followings. 1) Granitic magmatism in the Gyeongsang Basin were episodic. 2) Granitic rocks in the basin were derived from young (< 0.9 Ga) lower crust, and their isotopic signatures reflect heterogeneous source region. Geochemical and isotopic signatures of granitic rocks in the basin are difficult to explain by upper crustal contamination. 3) Granites in the Gyeongsang Basin have closely related to those in the San in Belt of the Inner Zone of Southwest Japan in terms of age, petrography, and isotopic and geochemical composition. 4) Sr-Nd isotopic signatures of the Onjeongri granite are relatively primitive compared with granitic rocks in the other parts of the Gyeongsang Basin and in the Inner Zone of Southwest Japan.