Lee, Young Seung;Kim, Seonguk;Kang, Eun Kyeong;Park, June Dong
Clinical and Experimental Pediatrics
/
v.50
no.5
/
pp.443-448
/
2007
Purpose : To evaluate the potential prognostic value of the antithrombin-III (AT-III) level in the children with acute lung injury (ALI), we analyzed several early predictive factors of death including AT-III level at the onset of ALI and compared the relative risk of them for mortality. Methods : Over a 18-month period, a total of 198 children were admitted to our pediatric intensive care unit and 21 mechanically ventilated patients met ALI criteria, as defined by American-European consensus conference, i.e., bilateral pulmonary infiltrates and $PaO_2/FiO_2$ lower than 300 without left atrial hypertension. Demographic variables, hemodynamic and respiratory parameters, underlying diseases, as well as Pediatric Risk of Mortality-III (PRISM-III) scores and Lung Injury Score (LIS) at admission were collected. AT-III levels were measured within 3 hours after admission. These variables were compared between survivors and non-survivors and entered into a multiple logistic regression analysis to evaluate their independent prognostic roles. Results : The overall mortality rate was 38.1% (8/21). Non-survivors showed lower age, lower lung compliance, higher PEEP, higher oxygenation index (OI), lower arterial pH, lower $PaO_2/FiO_2$, higher PRISM-III score and LIS, and lower AT-III level. PRISM-III score, LIS, OI and decreased AT-III level (less than 70%) were independently associated with a risk of death and the odds ratio of decreased AT-III level for mortality is 2.75 (95% confidence interval; 1.28-4.12) Conclusion : These results suggest that the decreased level of AT-III is an important prognostic factor in children with ALI and the replacement of AT-III may be considered as an early therapeutic trial.
Lee, Tae Seok;Kang, Geum Choon;Kim, Hyung Kweon;Moon, Jong Pil;Oh, Sung Sik;Kwon, Jin Kyung
Journal of Bio-Environment Control
/
v.26
no.4
/
pp.276-282
/
2017
The aim of this study was to compare and analyze air temperature and humidity distribution and energy consumptions according to using air circulation fans in single-span greenhouses. The greenhouses located in Cheongnam-myeon, Cheongyang-gun, Chungcheongnam-do, Korea. There were cherry tomatoes in the greenhouses and the size of greenhouses was as follows;ridge height : 3.2 m, wide : 6 m, length : 95 m. The heating system was composed of a hot-water boiler and 6 FCUs(Fan Coil Unit)-4 FCUs were on bottom with duct and 2 FCUs were installed at 2.0 m. A total of 18 air circulation fans(impeller's diameter : 230 mm) were bilaterally arranged in 2 rows in the experimental greenhouse. The sensors for measuring air temperature and humidity were located at a quarter and three quarters of a length. The height of sensors were 0.8 m, 1.8 m. To calculate energy consumption in greenhouses, water temperature at inlet and outlet in a water pump, volume of water were measured. Form February 3rd to March 23th, temperature, humidity and energy consumptions were measured during heating time(6pm~7am). In a greenhouse without fans, the average differences of temperature and humidity were $0.75^{\circ}C$, 2.31%, respectively. The operation of fans showed their differences to $0.42^{\circ}C$, 1.8%. The standard deviation of temperature and humidity between measuring points in the greenhouse with fans was lower than the greenhouse without fans. Total energy consumptions in a greenhouse without fans were 4,673 kWh. In the greenhouse with fans, the total energy consumptions were 4,009 kWh. The energy consumptions in a greenhouse with fans 14.2% were less than the greenhouse without fans. Therefore, air circulation makes temperature and humidity uniform and saves energy consumptions for heating.
Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.
Purpose : The efficacy of magnetic resonance imaging for evaluating coronary artery disease has been reported. In this study, we evaluated the usefulness of breath-hold segmented K-space cine MR imaging for evaluating the patency of coronary artery bypass grafts (CABG). Materials and Method s : Thirty eight patients with a total of 92 CABGs (36 internal thoracic arteries and 56 saphenous vein grafts) were evaluated using segmented K-space cardiac-gated fast gradient echo sequence (2D-FASTCARD) MR imaging. MR magnitude images were evaluated from the hard copies by two independent observers. A graft was defined as patent if it was seen as a bright small round area on at least two consecutive images throughout the cardiac cycle at a position consistent with the expected location for that graft. Results : MR images were obtained successfully for 23 patients (61%). The sagittal planes were most helpful in visualizing the cross-section of sapheneous vein bypass graft to left circumflex artery branch, whereas the transverse planes were used for identification of internal mammary artery grafts to left anterior descending coronary artery or its branch and identification of saphenous vein grafts to right coronary artery. Forty five grafts were visible using this MR technique, while the grafts were not visible on seven saphenous vein grafts and two internal mammary artery grafts. In two patients showing symptoms of myocardial ischemia, one or two bypass grafts were not visible. Imaging, perpendicular plane to a CABG was important to visualize the flow inside the CABG with maximum sensitivity. Conclusion : Evaluation of patency of the bypass graft was clinically feasible by 2D-FASTCARD MR imaging, whereas any invisible bypass grafts should be further studied by contrast-enhanced MR angiography or by conventional angiography for confirmation of abnormalities.
Kim, Eun Jung;Shin, Pyung Gyun;Jang, Kab Yeul;Kong, Won Sik;Han, Young Sook;Yoo, Young Bok
Journal of Mushroom
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v.12
no.2
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pp.96-106
/
2014
The primary objective of the present study is the characterization of the somatic hybrids of dikaryon-monokaryon (di-mono) crosses in mushroom breeding. We employed this technique for developing superior strains from Pleurotus ostreatus strains with 48 intraspecific hybrids of 12 combinations between six P. ostreatus strains and one P. florida strain. The results on the experiments of hybridization rate, nuclear DNA patterns, and colors and morphology of fruit-bodies, are presented. In di-mono crosses, somatic hybrids among Pleurotus strains showed 100% of crossability as seen in those between P. ostreatus and P. florida strains indicating that the nuclei of a dikaryon is inferred to be migrated to a recipient. 87.5% of the somatic hybrids among Pleurotus strains were similar to the donor dikaryons, and 12.5% of the somatic hybrids presented DNA patterns of both parents. In 16.6% of di-mono crosses between P. ostreatus and P. florida, the nuclear DNA patterns of all hybrids showed the same or similar patterns compared to the donor dikaryons. 70.9% of the hybrids between P. ostreatus and P. ostreatus were similar to the donor dikaryons and 12.5% of them presented the DNA patterns of both parents. 79.2% of fruiting body morphology of the hybrids among Pleurotus strains were similar to the dikaryons and 20.8% of them were similar to both parents. Interestingly, the morphology of all dikaryons were dissimilar each other. All hybrid strains between dikaryon P. florida and monokaryon P. ostreatus showed the fruiting body of which colors were similar to those of the dikaryon, while the hybrids between dikaryon P. ostreatus and monokaryon P. florida were showed the combined colors of both parents. Therefore, the fruiting body color of P. florida tends to be generally dominant. In conclusion, the present study provides a way to find out and suggest superior hybrid strains using the nuclear DNA patterns of hybrids between Pleurotus strains as well as the characteristics of their fruiting bodies. The advantages of the di-mono crossing are needs to be fully utilized in mushroom breeding because it is an ideal way to develop the superior strains of Pleurotus.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.18
no.2
/
pp.122-128
/
2007
This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.
Modeling of longterm runoff is theoritically based on waterbalance analysis. Simplified equation of water balance with rainfall, evapotranspiration and soil moisture storage could be formulated into regression model with variables of rainfall, pan evaporation and previous-month streamflow. The hydrologic response of water shed could be represented lumpedly, qualitatively and deductively by regression coefficients of water-balance regression model. Characteristics of regression modeling of water-balance were summarized as follows; 1. Regression coefficient $b_1$ represents the rate of direct runoff component of precipitation. The bigger the drainage area, the less $b_1$ value. This means that there are more losses of interception, surface detension and transmission in the downstream watershed. 2. Regression coefficient $b_2$ represents the rate of baseflow due to changes of soil moisture storage. The bigger the drainage area and the milder the watershed slope, the bigger b, value. This means that there are more storage capacity of watershed in mild downstream watershed. 3. Regression coefficient $b_3$ represents the rate of watershed evaporation. This depends on the s oil type, soil coverage and soil moisture status. The bigger the drainage area, the bigger $b_3$ value. This means that there are more watershed evaporation loss since more storage of surface and subsurface water would be in down stream watershed. 4. It was possible to explain the seasonal variation of streamflow reasonably through regress ion coefficients. 5. Percentages of beta coefficients what is a relative measure of the importance of rainfall, evaporation and soil moisture storage to month streamflow are approximately 89%, 9% and 11% respectively.
Kim, Eung-Gwon;Lim, Soon-Hwan;Kwon, Mi-Young;Choi, Young-Yuhn;Han, Ji-Hyoung
Journal of dental hygiene science
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v.14
no.1
/
pp.35-42
/
2014
In this study we analysed frequency and importance of tasks, and education needs of 114 people working in dental clinics to be a reference of dental hygiene curriculum development. The results are as follow: The order of performance frequency is management support, preventive dental treatment, dental treatment assistance and oral health education, and the order of importance level of tasks and education needs is management support, dental treatment assistance, preventive dental treatment and oral health education. There is no statistically significant difference of performance frequency by general characteristics. The tasks considered most important level depending on general characteristics are oral health education in age of 40s (p<0.05), dental treatment assistance in dental hygienists (p<0.05), management support in women (p<0.05), dental hygienists (p<0.05), and more experienced workers (p<0.05). The most need for Educations depending on general characteristics are oral health education in women (p<0.05), dental treatment assistance in women (p<0.001) and dental hygienists (p<0.001), and management support in Seoul region (p<0.05). The importance of tasks and education needs have correlations. The results showed management support and dental treatment assistance are considered important in dental clinics and most needed job competency for dental hygienists.
Purpose : The purpose of this study is to provide preliminary information on the hospice care needs of hospice volunteers. Methods : The sample of this study was obtained from those who completed the hospice volunteer education program in three different areas in Korea. This study was conducted by a self-administered questionnaire. The sample analyzed for this study contained 88 hospice volunteers. Frequency, percentage, mean, standard deviation, and logistic regression analysis were performed to produce the findings of this study. Results : The characteristics of the study sample were $40{\sim}49$ aged, middle class, christianity, married women with high school diplomas. They attended at the hospice center with less than 1 year experience. Majority of them had no family members who received a hospice care. The hospice care was strongly required in the field of information, particularly regarding their diseases and treatments. The identified hospice care needs were the prevention and treatment of gangrene in the field of physical needs, the maintenance of closer relationship with their doctors in the field of emotional needs, and the support of supporting medical insurance in the field of socioeconomic needs. The significant predictors were 'having hospice care taker among family members' in the field of the total hospice care needs and physical needs. Two predictable variables were found in the field of emotional needs. However, none were found to be a predictable variable in the field of information and socioeconomic needs. Conclusion : The findings or this study have a weekness of generalizability due to the sampling methodology used in this study. Thus, further research should be designed in relation to this topic with a probability sampling method.
Purpose: Recognition of impending death is crucial not only for efficient communication with the caregiver of the patient, but also determination of the time to refer to a separate room. Current studies simply list the events 'that have already occurred' around 48 hours before the death. This study is to analyze the predictability of each event by comparing the time length from 'change' to death. Methods: Subjects included 160 patients who passed away in a palliative care unit in Incheon. The analysis was limited to 80 patients who had medical records for the last week of their lives. We determined 9 symptoms and 8 signs, and established the standard of 'significant change' of each event before death. Results: The most common symptom was increased sleeping (53.8%) and the most common sign was decreased blood pressure (BP) (87.5%). The mean time to death within 48 hours was 46.8% in the case of resting dyspnea, 13.6% in the ease of low oxygen saturation, and 36.9% in the case of decreased BP. The symptom(s) which had the highest positive predictive value (PV) for death within 48 hours was shown to be resting dyspnea (83%), whereas the combination of resting dyspnea and confusion/delirium (65%) had the highest negative PV. As for the most common signs before death within 48 hours, the positive PVs were more than 95%, and the negative PV was the highest when decreased BP and low oxygen saturation were combined. The difference in survival patterns between symptoms and signs was significant. Conclusion: The most reliable symptoms to predict the impending death are resting dyspnea and confusion/delirium, and decline of oxygen saturation and BP are the reliable signs to predict the event.
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